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    California considers force-feeding inmates

    SACRAMENTO, Calif. — If dozens of hunger-striking California state prison inmates are so close to death they must be force-fed, the method will probably be less invasive than what was used on terror suspects at Guantanamo Bay, the prison system’s top medical services official said Tuesday.

    US military officials came under heavy criticism from human rights advocates when they snaked feeding tubes through the noses and into the stomachs of terror suspects who refused to eat.

    California prison officials won a court order Monday saying they could force-feed dozens of inmates who have been on a hunger strike for six weeks over solitary confinement conditions.

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    Dr. Steven Tharratt, director of medical services for the official who oversees medical care for California’s prisons, said if the state employs force-feeding, it’s most likely to be done by pumping nutrient-enriched fluids into the bloodstreams of unconscious inmates.

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    ‘‘It’s not really a forced re-feeding at that point,’’ Tharratt said. ‘‘It doesn’t evoke images of Guantanamo Bay or anything like that. It’s actually a totally different setting.’’

    State prison officials have struggled to deal with a hunger strike that started last month and, at its height, involved thousands of inmates. There are 45 inmates who have refused anything more than water, vitamins, and electrolytes since July 8 to protest the years-long isolation of gang leaders.

    Starvation weakens the immune system, leaving people more vulnerable to infections, said Dr. David Heber, director of the UCLA Center for Human Nutrition. Hearts also pump more slowly and depression can set in. The most common causes of death include irregular heartbeat or heart attack.

    Many of the hard-core strikers are likely to reach crisis stage in the next two weeks as they reach 60 to 70 days without significant nutrition, Tharratt said. They already are risking irreversible kidney damage, he said, and eventually they won’t be able to make decisions about their own care.

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    ‘‘They become basically listless, inactive, their speech starts to slow, they eventually become confused and eventually come to a stage where they’re not able to give consent one way or another,’’ he said.

    It is at that stage that Monday’s order by US District Judge Thelton Henderson of San Francisco could come into play. He has given state officials permission to disregard inmates’ do-not-resuscitate directives if the officials believe the inmates acted under duress, for instance under threats by gang leaders who organized the hunger strike on behalf of inmates held indefinitely in California’s Security Housing Units.