By Ian Miller, Ulster University
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. 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. 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.
Force-feeding is usually performed against the will of a sane patient. Most hunger strikers are not mentally ill. They hallucinate and feel emotionally stressed, but rarely develop severe mental health problems. This complicates matters. According to accepted medical ethics, sane patients have a right to refuse medical treatment (including force-feeding). Worse still, most force-fed prisoners insist that the procedure is used first and foremost to punish, degrade and harm. The tube’s passage through the body feels intensely painful and emotionally traumatic.
Although many people are familiar only with the 1980-81 hunger strikes that led to Bobby Sands and other prisoners dying, Northern Irish prisoners had been hunger striking since the Troubles began. Northern Ireland itself did not have force-feeding policies in place. Force-feeding became an issue only when the IRA, in 1972, commenced its bombing campaign in England where force-feeding policies had been in place since 1909 when the Leigh v. Gladstone set a legal precedent for authorising force-feeding.
In 1973, 8 IRA members were imprisoned for detonating car bombs in London. The ‘Winchester Eight’ included sisters Dolours and Marian Price, Gerard Kelly, Hugh Feeney, Robert Walsh, Martin Brady, William Armstrong and Paul Holmes. All hailed from Belfast and were aged between 19 and 24. They were dispersed to different prisons and treated as convict, not special category, prisoners. In November, the Winchester Eight commenced a hunger strike. Four of the prisoners soon capitulated. However, the Price sisters, Kelly and Feeney persevered with their fasts until mid-1974.
These prisoners were force-fed for over 200 days. Their goal? Simply to be transferred to a Northern Irish prison.
Dolours and Marian’s feedings received considerable international publicity. Even despite their role in IRA bombings, the public felt uneasy about two young ‘girls’ (as the press always described them) being brutally fed against their will. Notably, Kelly and Feeney’s force-feedings received relatively little attention. Only An Plobacht, an IRA newspaper, paid much attention to the male hunger strikers.
Force-Feeding: The Experience
A pamphlet published in Anderstown, Belfast, published an early account of Marian’s experiences:
At last it has happened, today, on the nineteenth day of hunger strike, I was forcibly fed. Unpleasant in the extreme. Actually what led up to the force-feeding was that on Saturday, after my bath, I clocked out and my blood pressure dropped a bit…so forcible-feeding was the next step…I really panicked as I thought I was suffocating.
It only takes a few minutes but it feels like an eternity. To crown matters, I was violently sick afterwards and brought everything up. I feel a wee bit better now but I am dreading going through it all again tomorrow. It’s only to be expected that after nineteen days without food, my stomach would reject the ‘feed’.
That same month, the Kerryman published part of a letter sent by Dolours to her mother which read:
I was scared stiff when I saw the tube and the wooden clamp for my mouth. The worst bit was when I couldn’t get my breath as the tube was going down. I really panicked then as I thought I was suffocating. It takes only a few minutes but it seems like an eternity.
In another interview, Marian described the horrors of the procedure as follows:
Four male prison officers tie you into the chair so tightly with sheets you can’t struggle. You clench your teeth to try to keep your mouth closed but they push a metal spring device around your jaw to prise it open. They force a wooden clamp with a hole in the middle into your mouth. Then, they insert a big rubber tube down that. They hold your head back. You can’t move.
They throw whatever they like into the food mixer. Orange juice, soup or cartons of cream if they want to beef up the calories. They take jugs of this gruel from the food mixer and pour it into a funnel attached to the tube. The force-feeding takes fifteen minutes but it feels like forever. You’re in control of nothing. You’re terrified the food will go down the wrong way and you won’t be able to let them know because you can’t speak or move. You’re frightened you’ll choke to death.
Image Source: Unknown
In February 1974, the Spectator published a particularly emotive description of the sister’s experiences which equated force feeding with sexual assault. The Spectator asked:
How many of us would want to live after being forcibly fed? This is an experience much worse than rape. The emotional assault on the person can be permanently damaging. The calculated administration of an experience such as forcible-feeding to someone who just cannot, or will not, eat is, to me, infernal…
…To restrain, even to punish, is one thing; to torture something very different. With the possible exception of the treatment of the mentally ill who may be violent and, indeed, act violently against themselves, it would seem that those who give instructions for forcible-feeding, and those who obey, should be judged like the torturers of the concentration camps, the rapists of certain Far East campaigns, the perverters of children.
The Spectator’s message was clear. Force-feeding was torture.
A Human Rights Issue?
In the 1970s, human rights activists were deeply concerned about torture. The Troubles coincided with growing international concern about prisoners’ lack of rights. Internationally, riots took place in prisons including Parkhurst on the Isle of Wight and Folsom, California. Both proved newsworthy. In summer 1972, protests erupted in 38 British prisons relating to institutional conditions. In this context, the hunger strikers soon found support from human rights and civil liberties groups.
However, it proved difficult to decisively establish force-feeding as a contravention of human rights. In December 1973, solicitor Bernard Simons applied for an injunction to prevent the Price sisters from being fed, but his application was dismissed. Public opinion remained divided. The Howard League for Penal Reform believed that the government was justified to authorise force-feeding, but others disagreed. In January 1974, the Irish Civil Rights Association claimed that force-feeding contravened the European Convention of Human Rights. The Association for Legal Justice condemned force-feeding as an assault upon human dignity and deprivation of prisoner rights. The Irish Civil Rights Association held a number of well-publicised protests. In December 1973, an effigy of British Minister for Home Affairs, Robert Carr, was burned with two tricolour-draped coffins outside Dublin’s passport office.
Feminists split on the matter. In 1974, British feminist magazine, Spare Rib, presented the force feedings as a women’s rights issue. One angry reader responded that feminists should not support all women, particularly those who ‘killed indiscriminately with bombs and guns just like the misguided men’. Another reader accused the magazine of ‘soiling the memory’ of the suffragettes by drawing parallels between the IRA and suffragettes. IRA violence mitigated against full support from the feminist movement.
The Ethics of Force-Feeding
Prison doctors were already viewed suspiciously due to their questionable enthusiasm for performing lobotomies to ‘cure’ criminal tendencies and routine diagnosing of ethnic minority prisoners as psychiatrically unstable. The Price sisters were force-fed in the context of a broader critique of prison medicine. Medical opinion on force-feeding was divided. In February 1974, eminent doctor and Conservative M.P., Tom Stuttaford, suggested on BBC Radio Four that force-feeding caused no physical suffering or permanent damage. According to Stuttaford, the procedure took only five minutes and claims of torture were grossly exaggerated.
However, other doctors remained unconvinced. Donald Gould, medical correspondent in the New Statesman, referred to the prison doctor’s ‘dual loyalty’ to their institution and the government. In Gould’s words:
When doctors force-feed a prisoner, they are acting as agents of the state, and not as servants of the patient in their care. The conflict between a doctor’s duty on the one hand, and to his patients on the other, is growing all the time – doctors as a group must fiercely defend the principle that their duty is to their patients.
Interestingly, the sisters had some sympathy for their doctors’ predicament. In their Prison Writings, the sisters wrote:
We’ve come to the conclusion that we must sympathise with the dilemma the doctors here find themselves in. We were just saying that they have all the training to counter illness, psychiatric illness, etc… But how can they fight idealism? There’s nothing about it in the medical books I’m sure. It’s unfortunate that they should have to be used in this way because they bear us no grudge or us them.
Our quarrel is with the Home Office only, and still I feel that it is a sad reflection on a very noble profession but then my opinion counts for nothing. As far as we are concerned our idealism is incurable, which from a medical point of view is frustrating for a dedicated doctor.
If prison doctors refused to admit that force-feeding was painful and traumatic, perhaps it could be proven some other way? In January 1974, 100 demonstrators congregated outside Wormwood Scrubs at an event organised by the Irish Political Hostages Campaign. Some protestors allowed themselves to be force-fed in the street. One elderly Wexford man, Charles O’Sullivan, had to be taken to hospital after his force-feeding. Brendan McGill, national organiser of Sinn Féin in Britain, vomited as a doctor inserted the tube down his throat. Famous Irish actress, Siobhan McKenna, had to be restrained by Dublin actors Niall Buggy and Máire Ní Ghráinne after volunteering to be fed. This public display of relentless vomiting graphically drew public attention to the experience of being force-fed.
The British Medical Association (BMA) and Irish Medical Association (IMA) refused to decisively condemn force-feeding. (The BMA had adopted a similar, uncaring stance during the suffragette hunger strikes of 1909 to 1914). It was left to individual doctors to campaign against force-feeding. In March 1974, a young London-based trainee GP, Berry Beaumont, publicly announced that force-feeding ‘may be justified in cases of insanity, but it is not in the case of two intelligent people who have made a decision not to eat until their legitimate demands have been met’. But what motivated Berry to protest?
In an interview with the author, Berry recounted that she had first become aware of the Price sisters’ prison treatment in February after a conversation with a young colleague who was politically active in the Irish Political Hostages Campaign. Berry had limited interest in, or understanding of, the Northern Irish Troubles. Nor did she ever have any personal contact with the two sisters. Her intervention, she recalled, stemmed purely from concern over a severe lapse in medical ethics. Berry was unaware of how commonplace force-feeding was in English prisons at the time. Indeed, it was the sister’s force-feedings which drew attention to this veiled, unsavoury part of prison life.
Throughout 1974, Berry attended Irish Political Hostages Campaign meetings as a spokesperson against force-feeding. She arranged demonstrations and public rallies in London, Liverpool and Dublin, at which she showed the funnels and tubes to passers-by. In May, Berry led a group of protestors to picket the headquarters of the British Medical Association in Tavistock Square, London, and delivered a letter signed by thirty-eight medical professionals to the Association’s secretary, Derek Stevenson, calling for a public statement to be made condemning the practice.
Image: Berry Beaumout leading an anti-force feeding protest, 1974. Kindly supplied by © Berry Beaumont.
By then, the Price sisters had been force-fed for 175 days. Beaumont publicly insisted that force-feeding was medically dangerous, psychologically damaging and ethically dubious, adding that it seemed clear that the procedure did not maintain health. Indeed, she claimed, the sisters had lost weight, their hair had fallen out and their teeth had become loose. Berry remembered that ‘the force-feeding demonstrations were quite potent actually – I like to think we made an impact on the BMA because we made demands on them to discuss it [force feeding] and we picketed outside the BMA for hours on the day that the ethicists were discussing it’.
The End of Force Feeding Policies
It took a prison death to persuade the Home Office to revoke force-feeding. In May 1974, Home Secretary, Roy Jenkins, announced his decision to end the sisters’ feedings. The New Statesman claimed that the prison doctors had in fact refused to perform any further feedings, due to feeling sickened by the procedure. A statement made by Clare Price, sister of Marian and Dolours, suggested that ‘the last time he [the prison doctor] force-fed her, he nearly killed her’. Whatever the reasons, this policy change raised the ominous prospect of the sisters starving to death instead. The sisters were even given their last rites. This raised questions about who would be to blame in the event of death. The sisters themselves? The doctors? The British government? A letter from Dolours, published in the Daily Express, read:
As we sit today, physically we are pretty worn out. Even to walk to the loo drains us and the least movement leaves my heart pounding like a big drum. Each day passes and we fade a little more but no matter how the body may fade, our determination never will. We have geared ourselves for this and there is no other answer.
Cognisant of the potential political ramifications of a death from hunger strike, Dolours added:
The Home Office say we are not near death. Well, if a couple of weeks isn’t near enough for them, I don’t know what will be. They’ll never live down the stigma that they let people die rather than transfer them to another prison. How ridiculous they will look to the rest of the world. I am only sorry I won’t be here to see it.
In the meantime, another IRA prisoner, Michael Gaughan, was hunger striking at Parkhurst alongside Frank Stagg. On 3 June, around a fortnight after Jenkins’ announcement, Michael died after being force-fed. His mother, Delia, described his plight in the Guardian as follows:
They force-fed him on Thursday and cut open all the back of his mouth. He showed it to me. His teeth were loose and there was the smell of death in the place. I hadn’t seen him for three years – he never wanted me to see him in prison. I went to see him with my son John, and we just didn’t recognise him.
He was just like something out of a Nazi concentration camp. He was so thin, all skin and bone. He knew he was dying and he told me he wanted to be buried in Ireland. Why did they treat him like that? He was a gentle, refined boy and he’d only been in London six weeks when he was arrested. How can anyone treat a boy like that? There’s more concern for cats and dogs than there is for people.
The jury reached an unsatisfactory verdict of death from ‘bronchial pneumonia and malnutrition’. However, sceptics pointed out that pneumonia could only occur if the tube had passed accidentally into the lungs, filling them with milk and liquid food.
Jenkins immediately granted a prison transfer to the Price sisters, Feeney and Kelly. However, he refused to authorise an inquiry. The BMA closed ranks and spent the summer producing a statement of guidance which stated that doctors who force-fed would not be deemed guilty of misconduct by the General Medical Council, and insisting that force-feeding had been ethical, despite the questionable death. On 17 July, Jenkins finally announced the end of force-feeding policies after nearly 70 years of controversy, in line with Scottish and Northern Irish policies.
The hunger strikers’ experiences changed overnight. During 1974, Frank Stagg was force-fed for 68 days. His survival suggests that force-feeding helped keep him alive. However, Stagg died on 12 February 1976 after enduring 62 days without food on a further hunger strike. Doctors were now obliged to stand by and let prisoners (such as Bobby Sands in the 1980-81 Maze/Long Kesh protest) slowly starve to death, an approach that clashed with their healing sensibilities. Five years later, the 1980/81 hunger strikes, and their accompanying deaths garnered international attention.
This article is based on a chapter in Ian Miller’s open-access book on the history of force-feeding which can be accessed entirely for free here: https://link.springer.com/book/10.1007/978-3-319-31113-5
 James McKenna, Farhat Manzoor and Greta Jones, Candles in the Dark: Medical Ethical Issues in Northern Ireland during the Troubles (London: Nuffield Trust, 2009).
 Ian Miller, ‘Silence, Distance and Neutrality: The Politics of Emotional Distress during the Troubles’, Social History, 46:4 (2021).
 Ian Miller, ‘‘A Prostitution of the Profession’? Forcible Feeding, Prison Doctors, Suffrage and Medical Ethics, 1909-14’, Social History of Medicine, 26 (2012).
 Linen Hall Library, Belfast, An Plobacht: Special Supplement on the Winchester Hunger Strikes (1974), p. 3.
 Linen Hall Library, Belfast, Venceremos Sisters: Prison Writings of the Price Sisters (Anderstown: Cathal Brugha Cumann, 1974), p. v.
 ‘Hunger Strikers’, Kerryman (25 January 1974), p. 33.
 Quoted in Ian Miller, A History of Force Feeding: Hunger Strikes, Prisons and Medical Ethics, 1909-74 (Basingstoke: Palgrave Macmillan, 2016), p. 200.
 ‘The Price Sisters’, Irish Press (6 February 1974), p. 6.
 For contemporary analysis, see Mike Fitzgerald, Prisoners in Revolt (Harmondsworth: Penguin, 1977).
 Diarmaid Ferriter, Ambiguous Republic: Ireland in the 1970s (London: Profile Books, 2012), p. 358.
 ‘Court Move on Hunger Strikers Ruled Out’, Irish Press (19 February 1974), p. 3.
 ‘Five IRA Bombers being Forcibly Fed’, Observer (2 December 1973), p. 3.
 ‘ICRA Backs Prisoners’ Demands’, Irish Press (29 December 1973), p. 3.
 ‘Justice Group Critical of Forced Feeding’, Irish Press (1 December 1973), p. 3.
 ‘Minister Burned in Effigy’, Irish Independent (17 December 1973), p. 11.
 ‘The Price Sisters: Some Letters’, Spare Rib, 24(June 1974), p. 26.
 Joe Sim, Medical Power in Prisons: The Prison Medical Service in England, 1774-1989 (Milton Keynes: Open University, 1990), pp. 103-28.
 BBC Archives, Ulster Folk Museum, ‘The World at One’, 1 February 1974.
 Donald Gould, ‘Doctors and Force Feeding’, New Statesman (7 June 1974), pp. 789-90 on p. 790.
 Venceremos Sisters, pp. 9-10.
 ‘Siobhan McKenna is Restrained’, Sunday Independent (20 January 1974), p. 3.
 ‘Let the Price Sisters Starve – Doctor’, Daily Express (12 March 1974), p. 5.
 Author’s interview with Berry Beaumont, 30 January 2015. For more on the force-feeding of convict prisoners, see Miller, History of Force Feeding, chapter 4.
 ‘Fresh Protests’, Guardian (6 May 1974), p. 5.
 Author’s interview with Berry Beaumont.
 ‘Price Sisters’, House of Commons Debates (23 May 1974), vol. 874 cols 599-602.
 Gould, ‘Doctors and Force Feeding’, p. 790.
 ‘Last Rites for Sisters’, Guardian (28 May 1974), p. 28.
 ‘Last Rites for Sisters’, Guardian (28 May 1974), p. 28.
 ‘IRA Warns over Price Girls’, Daily Express (31 May 1974), p. 2.
 ‘Irish Prisoner Dies on Hunger Strike’, Guardian (4 June 1974), p. 1.
 ‘Anger Over Sisters ‘Deal’: Five Demands by the Price Girls’, Daily Express (10 June 1974), p. 1.
 ‘Forced Feeding’, House of Commons Debates (10 June 1974), vol. 874 cols 471-2W.
 ‘The Law and Force Feeding’, British Medical Journal, i(29 June 1974), pp. 737-8; ‘Ethical Statement: Artificial Feeding of Prisoners’, British Medical Journal, ii(6 July 1974), p. 52.
 ‘Prisoners (Artificial Feeding)’, House of Commons Debates (17 July 1974), vol. 877 cols 451-5.