SACRAMENTO — California prison officials have obtained a federal court order to allow force feeding and other steps to keep hunger strikers alive, including those who have declared that they do not want such intervention.
The state argued in a Monday filing to U.S. District Judge Thelton Henderson that there is a "risk that inmates may be or have been coerced into participating in the hunger strike" and signed such declarations against their will.
Henderson agreed, ordering that the state may feed all prisoners who signed a "do not resuscitate" directive just before the July 8 start of the protest or since then, including those it says were coerced.
The judge's order also allows feeding of any prisoner who, according to a state doctor's determination, "has become incompetent to give consent or make medical decisions."
That includes inmates who may be unconscious, said Joyce Hayhoe, a spokeswoman for the prison medical office, which is run by a court-appointed receiver. "It's all based on a doctor's best medical judgment at the time," she said.
The chief spokeswoman for the California Department of Corrections and Rehabilitation, Deborah Hoffman, declined to answer questions about how that order would be interpreted, saying that those would be medical decisions.
Hayhoe said no inmates have reached the stage where involuntary feeding is needed. "We are being proactive," she said.
Medical journals say that after 40 days of fasting, the body begins to suffer more serious damage, and the risks of collapse or heart attack increase. Hayhoe said intervention may become needed as those who are fasting continue without food.
The strike continued Monday, its 43rd day, in six prisons. Sixty-nine inmates have refused meals since the beginning, and 67 have fasted for shorter periods, according to corrections officials.
The medical receiver's office said two protesters were referred Monday for medical treatment, including one who was sent to a local hospital for observation.
When it becomes necessary, Hayhoe said, doctors would mostly likely give prisoners nutrients through intravenous tubes. But she did not rule out the use of enteral feeding tubes, inserted down the nasal passage to pump liquid directly into the stomach, like the Navy uses to keep some hunger strikers alive at Guantanamo Bay prison in Cuba.
Jules Lobel, who represents many of the California protesters in their related lawsuit over solitary confinement conditions, said force-feeding "violates international law and generally accepted medical ethics" and "should only be used as a last resort. But here there are a number of reasonable alternatives."
The options include allowing hunger strikers to moderate and extend their protest by drinking juices or to negotiate with prisoners, both steps the state has said it will not take.
The provision to override recent healthcare directives was included in the state's motion, said Hoffman, because "we have information that inmates have been coerced into taking part in this hunger strike and signing 'do not resuscitate' directives, and this seeks to protect those inmates from serious harm."
The motion is also signed by lawyers for the medical receiver's office and the Prison Law Office, which represents California inmates in court on healthcare issues.
In the document, the medical receiver's office states that it takes no position on the other officials' request to ignore prisoners' recent directives. The Prison Law Office asks that the order be limited to only the current hunger strike.
Also on Monday, California leaders continued to seek ways to comply with a federal court order to remove about 9,600 inmates from state lockups by the end of the year to reduce crowding. Courts have ruled that overcrowding has led to inadequate care of prisoners.
"We are not going to do a mass release," Gov. Jerry Brown said in an interview at a Lake Tahoe environmental summit. The state "will have to make some investment."
The Democratic governor's assurance appeared to contradict his administration's recent court filings on the population issue. An Aug. 9 appeal filing with the U.S. Supreme Court included a warning that the mandate to reduce crowding would, in fact, lead to a mass release of inmates and endanger public safety.
Brown is awaiting a response from the high court on the overcrowding issue. In the meantime, he has asked the Legislature for $450 million to pay for private prison beds and other alternative housing, which could swallow a major chunk of the state's $1.07- billion emergency fund.
Even with those relocation options, about 1,000 inmates could be released from custody, according to a plan that state officials are considering.
Senate leader Darrell Steinberg (D-Sacramento) said Monday that he believed the need for funds to resolve the crowding issue could be addressed before the Democrat-controlled Legislature adjourns for the year Sept. 13.
Senate minority leader Robert Huff (R-Diamond Bar) said the state is in its current predicament because Democrats ignored Republicans' pleas to build more prison capacity.
"The chickens are coming home to roost now," Huff said.
Times staff writers Melanie Mason and Patrick McGreevy contributed to this report.