‘The Instrument of Death’: Prison Doctors and Medical Ethics in Revolutionary-Period Ireland, c.1917

Abstract

In 1917, emerging Irish playwright, Sean O’Cathasaigh (or Sean O’Casey), wrote this piercing indictment of his close friend Thomas Ashe’s treatment at the hands of the medical staff at Mountjoy Prison, Dublin. Thomas was serving a two-year sentence of hard labour for sedition when he went on hunger strike in protest against the prison authorities’ refusal to grant him political prisoner status. As O’Cathasaigh lamented, he died soon after being force-fed. Thomas’s controversial death was set against a backdrop of mounting political conflict across Ireland as well as the international milieu of the First World War. This chapter examines force-feeding in revolutionary-period Ireland, and the contours added to force-feeding debates as they surfaced in a new national and socio-political context. It focuses specifically on the problem of medical participation in hunger strike management. As demonstrated in the opening chapter, the careers of English prison doctors such as William Cassells gained considerable complexity once the Home Office called upon them to force-feed. Prison doctors found themselves subject to public censure, accused of colluding in political agendas, and exposed to legal action. During conflicts, medical professionals are often called upon to aid political and military agendas. Many of them work in prisons and encounter highly politicised prisoners. In these circumstances, their role becomes complicated. Even in ‘normal’ times, prison doctors operate in a ‘dual loyalty’ to the ethical norms of their profession and the needs of their institution. As Joe Sim argues, prison doctors have always proactively helped to enforce discipline; they are crucial figures in the disciplining of the body. 2 According to Sim, prison doctors have not simply benevolently healed prisoners but also helped to enforce the apparatus of physical and psychological control that surrounded them. This situation gains added intricacy in conflict zones, particularly when prison doctors feel obliged to support state objectives. They do things that clash with accepted medical ethical standards and which would seem unacceptable in times of peace. At worst, prison doctors associate themselves with torture. Force-feeding is often considered as one of these lapses in medical ethics.