The World Medical Association today released the text of a letter it has received from Professor Veli Lok, an internationally renowned orthopaedic surgeon in Turkey, about the increasing pressure facing doctors in Turkey to force feed political prisoners.

In his letter Prof. Lok warns the WMA of an intensifying slander campaign against the Turkish Medical Association and the fact that individual physicians who refuse to co-operate in the forced feeding of prisoners are being targeted by the Turkish authorities with threats of legal action. The latest information is that 2018 prisoners are on hunger strike, 90 of them on death fasts.

Last year, Prof. Lok himself was sentenced to live under censorship for five years after facing charges relating to press statements he made about the ill treatment of human rights defenders. He accepts that he is taking a personal risk in allowing his letter to be published, but says: "Our ethical responsibility causes us to tolerate probable harm".

The full text of the letter is as follows:

Dear Delon Human,

As a physician I'm seriously concerned about the recent developments in our country, which escalated with interventions towards prisons. As you will easily understand I feel myself deeply bound to the World Medical Association (WMA), as I do feel the same concerning the Turkish Medical Association (TMA). Therefore I felt, that it would be appropriate to briefly share the recent developments and my anxiety with you. As you know, the interventions by the security forces towards 20 prisons started on the 19th of December, 2000. Due to official statements 24 prisoners and two members of the security forces died, 79 prisoners were injured. The health stage of most of the injured is still serious. Furthermore the intervention towards 423 political prisoners in Istanbul Umraniye Prison still continues. Therefore an increase of death cases is expected. By this interventions the process of hunger strike and death fast, which deeply wounded the public conscience during the last two months, has reached a new level. The purpose of the prisoners' action is to end the isolation-threat and to stop the F-Type Prison Project, which doesn't even meet the minimal requirements of standards for the prisoners, which were set by the UN. The TMA took a position about the hunger strike and death fast, which was corresponding with the ethical principles of the WMA. To achieve an end of the action before death cases arise, the TMA went into the prisons by approval of the authorities, made health controls and forwarded the necessary information. Moreover the Vice-President of TMA participated in the mediation team and spoke with both sides; the prisoners and the Ministry of Justice. Unfortunately the negotiations had no positive result. I'm sorry to say, that the TMA, which has accurate experience concerning hunger

strikes and acted in accordance with ethical principles, became the target of an intensifying slander campaign before the interventions started. Even some directors of medical faculties joined the media and government in this campaign. The aim was to legitimate the intervention and the attempts to feed the prisoners by force. The Ministry of Health sent an order to the hospitals to feed the prisoners by force and pointed out that physicians who refuse to co-operate will be target of judicial consequences. In spite of the oppressive intervention the prisoners carry on with the hunger strike and death fast and some reached the 64th day. TMA is opposing the intervention and a feeding by force, but it is under serious pressure. Under these circumstances it is not possible for physicians, who want to take a position corresponding with ethical principles to make their decisions freely - as it is stated in the declarations of the WMA. Therefore it seems to be a necessity to remind the Turkish government (the Prime Minister, the ministries of health, justice, etc.) of the ethical principles stated in elemental documents and to support the TMA, visible for the media and public.

Dear Mr. Human, I want to speak out my sincere regards and hope for every possible effort to lift the pressure on the TMA, which is acting in correspondence with medical ethics stated in many decisions of the general assembly of the WMA, first of all the "Tokyo Declaration".

Yours respectfully,
Prof. Dr. Veli Lok