Proposed legislation to permit the force-feeding of Palestinian prisoners on hunger strike is pitting Israel's government against the country's main doctors' association and other rights groups, which contend the practice amounts to torture.
Prime Minister Benjamin Netanyahu has reportedly asked to fast-track the bill as a hunger strike by dozens of Palestinian detainees entered its sixth week.
At least 65 of 290 participating detainees have been hospitalized since the first group began a hunger strike on April 24. Many are administrative detainees, held for months or years without charges.
There have been near-daily Palestinian demonstrations backing the prisoners, including one in the West Bank on Wednesday in which dozens of university students threw stones at Israeli soldiers who responded with tear gas.
Families of hunger strikers say they support the fast, despite the risks.
"My husband is in Israeli jails without knowing why and when this nightmare is going to end," Lamees Faraj said of her husband, Abdel Razeq, a member of a small, hard-line Palestine Liberation Organization faction who has been in administrative detention for nearly eight of the last 20 years.
Faced with the second large-scale Palestinian hunger strike in two years, Israel's government is promoting a bill that would allow a judge to sanction force-feeding if an inmate's life is perceived to be in danger.
A judge must not only consider the prisoner's wishes, but also possible damage to the state, said Yoel Hadar, a legal adviser in the Public Security Ministry, which initiated the bill.
A death in custody could trigger prison riots or unrest in the Palestinian territories or elsewhere, he said. "We want the judge to take into consideration what will happen to the country if something happens," Hadar said.
There has been mounting opposition from Israel's medical establishment, with the Israel Medical Association urging physicians not to cooperate.
"It goes against the DNA of the doctors to force treatment on a patient," spokeswoman Ziva Miral said. "Force-feeding is torture, and we can't have doctors participating in torture."
She noted that the World Medical Association, an umbrella for national medical associations, opposes the practice. The WMA said as recently as 2006 that "forcible feeding is never ethically acceptable."
Israel's National Council of Bioethics has also weighed in, saying it opposes the proposed bill.
Another group, Physicians for Human Rights-Israel, contacted the World Medical Association last month, asking that it help stop the legislation.
In a letter to the WMA, the Israeli group reiterated the ethical concerns raised by others and added that "the true motivation ... is to break the spirit and protests of the hunger strikers.".
Netanyahu's spokesman, Mark Regev, declined to comment on the report, but confirmed the government supports the bill.
The US-based Physicians for Human Rights said it is currently not aware of prisoners being force-fed anywhere except Guantanamo, but that it is often difficult to get access to prisons to verify their practices. There have, however, been past cases of force-feeding, including of prisoners from Germany's radical leftist Red Army Faction in the 1970s.
Hadar said force-feeding would be a last resort. Hunger strikers would be represented in legal hearings and physicians would not be compelled to participate, he said.
He said force-feeding is meant to save lives, while acknowledging other considerations at play.
"People go on a hunger strike for political reasons ... and the consequence could be political damage to the state," he said. "The state also has the right to stop the strike."
Qadoura Fares, an advocate for Palestinian prisoners, said Palestinians would seek international condemnation of Israel if the legislation is passed.
Existing law prohibits the treatment of patients, including prisoners, against their will, with extreme cases referred to an ethics committee, said Amany Dayif of Physicians for Human Rights-Israel.
Sivan Weizman, a spokeswoman for the Israel Prison Authority, said she recalls one or two isolated cases of force-feeding prisoners in the 1980s. Fares said three prisoners died from complications of force-feeding at the time.
Since capturing the West Bank, the Gaza Strip and east Jerusalem in 1967, Israel has imprisoned tens of thousands of Palestinians for a range of politically motivated offenses, from stone throwing and membership in outlawed groups to deadly attacks on Israelis.
The Palestinians want a state in the three territories and have staged two uprisings since 1987 in hopes of hastening an Israeli withdrawal.
Currently, some 5,000 Palestinians are imprisoned by Israel, including 191 in administrative detention.
Administrative detainees can be held for up to six months at a time without charges, with the detention and any extensions approved by a judge. The Shin Bet security agency can present evidence that is kept from defense lawyers.
Israel says administrative detentions are an important tool in preventing attacks by militants. Rights groups say international humanitarian law permits administrative detention in exceptional cases, but that Israel is out of bounds with its large-scale use of the method.
Two years ago, some 2,000 administrative detainees and other prisoners launched a mass hunger strike to end the practice and improve prison conditions.
In negotiating an end to that strike, Israel promised to scale back administrative detentions, said Dayif of Physicians for Human Rights. She said the number of detainees dropped by a few dozen, but has crept up again.
The second large-scale strike began in April.
None of the 65 prisoners hospitalized so far are in a life-threatening condition, said Weizman, the prison authority spokeswoman.
Dayif put the number of hospitalized hunger strikers at more than 70, including 15 believed to be in critical condition.
The families wait and worry, including Amani Ramahi, whose jailed husband, Mahmoud, is a West Bank legislator for the Islamic militant group Hamas. Israel considers Hamas a terror group because it has killed several hundred Israelis in attacks since the late 1980s.
Ramahi said her husband relayed a message from prison that the hunger strikers are determined to continue, "even if they die, because they want to put an end, once and for all, to their suffering."