During a recent hearing on the treatment of Guantánamo detainees in Washington, D.C., the debate turned to various medical treatments of several prisoners who are on a hunger strike.

Of particular concern was whether the use of olive oil to lubricate the feeding tube was, as the government lawyer argued, a "cultural preference" for a Syrian man, or a dangerous alternative that was being used as punishment.

Dr. Steven Miles from the Center for Bioethics at the University of Minnesota was the third expert to testify publicly in the case of Abu Wa'el Dhiab, a Syrian detainee who has been cleared for release but is nonetheless being detained by a congressional order.

Miles, one of the world's foremost experts on torture procedures, was adamant: "This should never have happened," the doctor said. "One doesn't have to make very many salads to know that olive oil is not water soluble."

Always forthright, Miles delivered the most critical view among doctors of treatment of hunger strikers in Guantanamo.

"This is an abuse of a prisoner," Miles told the court.

"Every time you insert a tube, bits of lubricant drop into the lung," he said. "The lungs can clear water, but not oil, and it can lead to fibrosis of the lung."

Dhiab and other detainees will, theoretically, be released eventually, and could suffer serious health issues due to their treatment. If they do, they will not have access to their medical records, Miles said. None has been tested for lung problems.

Miles doesn't know who came up with the idea to coat the feeding tube with olive oil, but he says it doesn't pass the medical test. Whether someone in the military thought it would be culturally sensitive because the detainees are familiar with the taste, or whether someone was being "cute" is not known.

"What I found is that the feeding procedures have been modified from acceptable practice to make it essentially a punishment for anyone on a hunger diet, or anyone they felt like punishing," Miles said.

Miles also testified that the feeding tubes should be left in the detainees, not removed and inserted several times a day, and that prisoners were being force fed "when not medically necessary." He also questioned the use of restraints to hold the detainees down.

A U.S. district judge ruled in May that hunger strikers can be force-fed. The dispute now is to make sure it is done humanely and follows accepted procedures. Dhiab's case is one of the first court proceedings over controversial procedures used by military doctors in Guantanamo.

There's no question why Miles was called in as an expert. He has published four books and 200 articles on medical ethics, human rights and end-of-life care. He has analyzed the medical handling of prison hunger strikes in Turkey and he's on the board of Center for Victims of Torture in Minneapolis. He also has a website (www.doctorswhotorture.com) to keep track and hold accountable physicians around the world who participate in government-backed torture.

In 2011, Miles was the key witness against Dr. Wouter Basson, a South African physician called "Dr. Death" who was convicted of participating in torture during apartheid. That case is expected to be decided by late November.

While testifying last week, Miles called some of the treatments "a form of punishment that is wrapped around the business" of feeding detainees.

Anticipating the comments I will get on this column, I asked Miles why we should care about how prisoners, and possible terrorists, are treated.

"Many have not been charged. None got due process," Miles said. "The U.S. government said this guy was not guilty of anything."

jtevlin@startribune.com • 612-673-1702

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