The Hippocratic Oath is an ethics code for physicians that was historically taken by doctors, and it is one of the best-known Greek medical texts in the Western world. It emphasizes following ethical standards such as doing beneficial treatment, avoiding harm, and keeping patient information confidential. Wikipedia News-Medical
But, like the infamous Doctor Mengele, this oath has been discarded by some:
ICE given permission to force-feed Cuban hunger striker with gastric tube
Exclusive: court orders seen by Guardian show agency given approval to fit Texas detainee with tube without his consent
José Olivares in New YorkSat 5 Sep 2026 11.00 BSTShare
Federal immigration officials quietly received permission from a judge in recent weeks to force-feed a detained Cuban hunger striker inside a Texas detention center, including with the use of a rare, nonconsensual surgical procedure, court records reveal.
The man is likely the 19th hunger striker in Immigration and Customs Enforcement (ICE) detention where the agency has had an application approved to conduct “involuntary medical procedures” since January 2025. The rising number of cases under the second Trump administration has alarmed advocates amid wide-ranging accusations of mistreatment inside facilities nationwide.
Court orders from the southern district of Texas federal court seen by the Guardian suggest ICE followed through with force-feeding via a nasal tube on the Cuban man in August, since agency officials successfully requested this week that the court order be extended. He is currently detained at the Montgomery ICE processing center, a privately-run detention facility near Houston.
The Department of Homeland Security (DHS), the parent agency of ICE, said on Thursday evening the man had “resumed eating and drinking again” and was not being force-fed. The DHS did not answer whether the man had broken his hunger strike this week after the latest court order, or how many times he had been force-fed prior.
The new order had given ICE permission to operate on him to fit a surgical feeding tube without his consent.
The Guardian is not naming the man because efforts to contact him have been unsuccessful. Like in all force-feeding cases, the majority of his court records are sealed, concealing many details from the public.
During a prolonged hunger strike, ICE will request permission from a federal judge to conduct force-feeding, forced hydration and other measures.
Typically, after a judge approves the request, detention center guards hold down a hunger striker while medical staff forcibly insert a tube through the person’s nose and down their throat, and pump nutritional liquid into their stomach.
But in this latest case in Texas, ICE also received permission to force-feed the Cuban hunger striker through a “percutaneous endoscopic gastrostomy” tube insertion. This is a surgery in which medical staff make an incision in a person’s abdomen, insert a tube that remains in place indefinitely until it is surgically removed again and pump liquid directly into the stomach. This procedure has not been previously identified in other force-feeding cases reviewed by the Guardian.
“The cruelty of the extreme tactics at ICE’s disposal to end lawful protest, including forcibly cutting into a protester’s body to insert a tube in their stomach, underscores the horrors happening outside our view in ICE detention centers,” said Savannah Kumar, a staff attorney at the American Civil Liberties Union (ACLU) of Texas. “ICE’s brutal use of involuntary medical procedures on hunger strikers demonstrates how degrading conditions have gotten in these hidden places, which is often exactly what hunger strikers are protesting in the first place.”
Last month, the Guardian published a series of stories about the extent of ICE’s force-feeding practices under the second Trump administration, with the agency getting the green light to perform involuntary medical procedures in 18 hunger strike cases – and the latest being the 19th.
“The high number of verified court orders since January 2025 raises serious concern,” said Eunice Cho, an immigrant and civil rights attorney who has extensively documented forced treatment on hunger strikers in ICE detention.
Cho added that the high number “suggests several possibilities, none of which are positive”, including that conditions are so bad that more people are hunger striking in protest, and that officials “are more frequently failing to attempt to resolve the issue in a less confrontational and dangerous manner, instead resorting to forced medical intervention”.
The Cuban man was arrested by ICE on 22 July and was declared a hunger striker three days later, court records show. The Montgomery facilityholding him is run by the private prison company GEO Group.
A GEO Group spokesperson referred all questions to ICE. The US attorney’s office in the southern district of Texas, which is representing ICE in the latest court proceedings, did not respond to a request for comment.
An ICE official and a doctor at the facility requested permission to force-feed the Cuban hunger striker in August, filings show.
On 19 August, federal judge Andrew Hanen gave permission for ICE to force-feed the hunger striker. And on 1 September, ICE requested the judge extend his order.
This Wednesday, Hanen extended the order, which is set to expire in mid-September. It includes the option for ICE touse the surgical tube insertion.
Like in many cases reviewed by the Guardian, the Cuban hunger striker does not have any current legal representation.
“The fact that this person lacks legal representation in a process where the government seeks to subject him to an invasive, involuntary medical procedure performed without consent is a tragedy, and a clear failure of our justice system,” Cho said. “The secretive nature of these cases, and the opacity of the legal process by which the government brings these motions, should concern us all.”
According to a DHS spokesperson, the Cuban hunger striker entered the US unlawfully in 1980 and was ordered deported in 2004. The DHS claims he was previously convicted of “aggravated assault with a weapon, aggravated battery, drug possession, and carrying a concealed firearm”. The spokesperson added that he “received due process and will remain in ICE custody until removed from the United States”.
The DHS also said facilities distribute proper food, hygiene, phone and other basic services, and that “during hunger strikes, ICE continues to provide three meals a day, delivered to the detained alien’s room”.
The Trump administration had previously refused to acknowledge the force-feeding of hunger strikers in ICE detention, until later into the Guardian’s investigation confirming the practice.
In the mid-1970s, the force-feeding of Northern Irish prisoners led the World Medical Association (WMA) to establish stricter guidance on how doctors respond to hunger strikes. Force-feeding, always considered an ethically dubious practice, had been used in British and Irish prisons since the suffragette hunger strikes of 1909-14. The WMA criticised doctors who force-fed for having abandoned the Hippocratic Oath to instead helping governments participate in torture and abuse. This was a direct response to medical ethical issues that arose during the Troubles.
‘Medical neutrality’ and ethical standards often proved difficult to maintain in a complex conflict.[1] A desire to appear ‘neutral’ encouraged some medical professionals to turn a blind eye towards, or remain silent about, medical activity that breached ethical standards.[2] In one of our own podcast episodes, former prisoner Séanna Walsh describes the fraught relationships that formed between prisoners and their doctors. When force-feeding was used between 1973-74, a global controversy erupted.
What is Force-Feeding?
Force-feeding involves inserting a tube into the mouth of a prisoner which is pushed downwards into the stomach, causing patients to gag, choke and even vomit over themselves. Once the patient eventually calms down, medical staff pour liquid food into the tube through a funnel. Force-feeding can also be performed using a nasal tube. It shares similarities with ‘artificial feeding’, used to keep alive mentally ill patients who refuse food, but important differences exist.
A hunger strike has been defined as “an action in which a person or persons, with decision-making capacity, refuses to ingest vital nourishment until another party accedes to certain specified demands.“1 It is a high-stakes protest strategy undertaken by incarcerated individuals to bring attention to a set of grievances. Grievances may include poor facility conditions, unjust modes of punishment, lengthy detention, denial of due process, imminent deportation, and inadequate access to legal representation. For many detainees, it is an option of last resort and represents a desperate appeal to be heard after exhausting other means of recourse. Between 2015 and 2020, approximately 1600 individuals held in immigration detention facilities by the United States Immigration and Customs Enforcement (ICE) agency participated in a hunger strike.2
Clinicians may be asked to care for with patients who hunger strike or subsequently stop a strike, especially when they work in a carceral setting, or in a facility near a detention center. They should be aware of the ethical challenges of treating individuals who choose to stop eating in such a setting, and the clinical management of those who break their fast. Hunger strikes in ICE detention represent an illustrative case study for exploring the clinical and ethical challenges faced by clinicians involved in the care of these individuals. Despite the dire health complications that can arise from fasting, it is unethical for clinicians to engage in forced feeding or forced hydration measures. Knowledge about the complications and the ethics of hunger striking and force feeding is important for clinicians who work in detention facilities as well as those who care for them when they are referred to hospitals.
A new Immigration and Customs Enforcement detention facility on this site in Conroe, Texas, will house up to 1,000 immigrants at a cost of $44 million a year to U.S. taxpayers.
The Trump administration wants to expand its network of immigrant jails. In recent months, Immigration and Customs Enforcement has called for five new detention facilities to be built and operated by private prison corporations across the country. Critics are alarmed at the rising fortunes of an industry that had fallen out of favor with the previous administration.
The Joe Corley Detention Facility is a sprawling complex surrounded by shiny concertina wire located in Conroe, Texas — about an hour north of Houston.
ICE spends more than $2 billion a year on immigrant detention through private jails like this one.
The Corley facility is owned by GEO Group, the nation’s largest private prison company.
ICE and the U.S. Marshals Service pay GEO $32 million a year to house, feed and provide medical care for a thousand detainees.
Between 2013 and 2014, Douglas Menjivar was one of those ICE detainees.
Menjivar says he was raped by gang members in his cell, and when he reported it to the medical staff they mocked him. ICE found the rape allegation to be unsubstantiated. His lawyer has filed a federal civil rights complaint.
Menjivar also says he was forced to work for a dollar a day.
“Lots of things happened to me in Conroe,” he says.
He is a 42-year-old Salvadoran who entered the country illegally and is charged with violating a prior deportation. He’s out now, fighting to get legal status in immigration court.
Menjivar has become a bitter critic of immigrant detention centers, which are supposed to be holding facilities for civil matters, not prisons for meting out punishment.
GEO “strongly refutes” these claims and plans to fight them. In an emailed statement, the company says detainee labor is voluntary and immigrant workers are paid a dollar a day because that’s the rate set by ICE. GEO also says it provides “culturally responsive services in safe and humane environments,” and that all of its facilities comply with national detention standards.
Here’s GEO’s full statement defending its facilities:
“GEO has a long history of providing culturally responsive services in safe and humane environments that meet the needs of individuals in the care and custody of federal immigration authorities as confirmed in the U.S. Department of Homeland Security Advisory Council report in 2016 on privately operated ICE facilities. As a matter of long-standing policy, GEO does not take a position on or advocate for or against any immigration policies, such as the basis for an individual’s detention or the length of detention.”
GEO also rebuts the class-action lawsuit filed in Colorado:
“GEO has consistently, strongly refuted the allegations made in this lawsuit, and we intend to continue to vigorously defend our company against these baseless claims. The volunteer work program at all immigration facilities as well as the minimum wage rates and standards associated with the program are set by the Federal government under mandated performance-based national detention standards. Our facilities, including the Aurora, Colo. Facility, are highly rated and provide high-quality services in safe, secure, and humane residential environments pursuant to the Federal Government’s national standards.”
“I don’t get the impression that the Trump administration has any interest in implementing new detention reforms. If anything it looks like they may be eliminating some safeguards,” says Kevin Landy, who was director of the Office of Policy and Planning at ICE for six years. That office tried to reform federal oversight of immigrant jails during the Obama administration. He also advocated for raising the pay rate of a dollar a day, which was set in 1974.
“I believe contractors save a lot of money by using detainee labor because they’re performing work that would otherwise have to be performed by paid employees,” Landy says. That work includes cooking and cleaning the facility.
But now, ICE is shutting down Landy’s old office and moving the functions elsewhere in the agency.
“It is incredibly scary to contemplate the notion that ICE would be removing even the dysfunctional oversight that currently exists,” says Carl Takei, senior staff attorney with the American Civil Liberties Union’s National Prison Project.
At the same time, immigration authorities want to increase detention space. In its latest budget request, ICE has asked for more than 51,000 detainee beds — a 25 percent increase over the last year.
ICE, however, believes lockups are the surest way to get detainees to show up in immigration court. So ICE is turning once again to the private prison industry.
“I think what’s driving this is the administration wants to make a point that they’re serious about immigration enforcement,” says Lauren-Brooke Eisen of the New York University School of Law. She’s author of a new book, Inside Private Prisons.
“They’re going to put their money where their mouths are and I think they’re going to invest in more immigrant detention centers,” she continues.
The two largest private corrections corporations, GEO Group and CoreCivic, each gave $250,000 to Trump’s inaugural festivities.
The Obama administration took the extraordinary step of phasing out contracts with private prisons that house immigrants convicted of crimes committed in the U.S. The Justice Department found these prisons fall short on safety and security, and are no cheaper than those run by the federal government.
Since Trump took office, the Bureau of Prisons has restored those contracts.
And ICE is proposing five new private detention centers — in Detroit, Chicago, St. Paul, Salt Lake City and south Texas.
Traditionally, ICE has put its jails in border states close to where most people were caught. But immigration agents under Trump have been much more aggressive in the interior.
Quick facts Senior Judge of the United States District Court for the Southern District of Texas, Judge of the United States District Court for the Southern District of Texas …
Hanen maintained chambers in Brownsville, Texas from 2002 until 2018, when he relocated to Houston, also within the Southern District.[5]
Notable cases
During the sentencing of a convicted child smuggler in December 2013, Hanen sharply criticized the United States Department of Homeland Security in an opinion that “veered far from the matter at hand” and “that quickly won rave reviews on right-wing news sites.” Not only did he criticize the policy of reuniting children with their illegal immigrant mothers, he further rebuked the department for not prosecuting this child’s mother.[6] Hanen wrote, “DHS should cease telling the citizens of the United States that it is enforcing our border security laws because it is not. Even worse, it is helping those who violate these laws.”[7] In February 2015, Hanen granted the State of Texas’s motion for a nationwide preliminary injunction barring President Barack Obama from carrying out the Deferred Action for Parents of Americans (DAPA) program.[6] In United States v. Texas, that ruling was affirmed by an equally divided Supreme Court of the United States on June 23, 2016 (with an eight-member bench due to the death of Justice Antonin Scalia).[6]
Hanen made national news for related assertions and sanctions which were later withdrawn. On May 19, 2016, while the case was awaiting a decision at the Supreme Court, Hanen demanded that some 3,000 Department of Justice lawyers in 26 states take ethics classes, and ordered other sanctions for those who argued Texas v. United States, involving President Obama’s immigration executive actions.[8][9] Hanen did not explain why he extended his sanctions to attorneys who had no involvement in the case.[10] Hanen accused Justice Department’s lawyers of lying to him during arguments in the case, and barred them from appearing in his courtroom.[8] He accused the department of “a calculated plan of unethical conduct”.[11] Hanen further ordered Attorney GeneralLoretta Lynch to appoint someone within the department to ensure compliance with his order.[11]
Hanen also ordered U.S. immigration officials to turn over, within weeks, the names and addresses of 50,000 people who received deferral under the expanded deferred action initiative.[9] The National Immigration Law Center, the American Civil Liberties Union (ACLU) Immigrants’ Rights Project, and the ACLU of Texas petitioned the United States Court of Appeals for the Fifth Circuit to vacate the order or postpone the deadline.[9] Separately, the Justice Department argued in a filing in the district court that Hanen’s ordered sanctions “exceed the scope of [the court’s] authority and unjustifiably impose irreparable injury on the Department of Justice, the Department of Homeland Security and thousands of innocent third parties.”[10][12] The Justice Department also argued that additional ethics courses could cost up to $7.8 million over five years.[9]
On June 7, 2016, Hanen stayed his order requiring ethics courses for federal attorneys and requiring U.S. immigration officials to turn over the names and addresses until August 22, 2016.[9] On January 19, 2017, Hanen withdrew the sanctions in the order issued on May 19, 2016, as well as his demand that Immigration and Customs Enforcement (ICE) turn over personal information of 50,000 DACA recipients, stating: “This Court finds upon [DOJ’s] newly filed evidence, that the statements in question, though repeated on multiple occasions, were not the product of a bad faith intent to deceive the Court or that they were made with malice.”[13]
Retired, living in the Scottish Borders after living most of my life in cities in England. I can now indulge my interest in all aspects of living close to nature in a wild landscape. I live on what was once the Iapetus Ocean which took millions of years to travel from the Southern Hemisphere to here in the Northern Hemisphere. That set me thinking and questioning and seeking answers.
In 1998 I co-wrote Millennium Countdown (US)/ A Business Guide to the Year 2000 (UK) see https://www.abebooks.co.uk/products/isbn/9780749427917
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