E/CN.4/2006/120 page 23 respects. Most importantly, the United States Principles apply only to health professionals in a “professional provider-patient treatment relationship”.120 Consistent with this role distinction, the United States acknowledges that psychiatrists and psychologists have participated in Behavioural Science Consultation Teams, which provide expertise for interrogations, but justifies their participation on the grounds that these health professionals are not in provider-patient relationships with detainees. It contends, moreover, that the purpose of such Teams is to assist “in conducting safe, legal, ethical and effective interrogations”.121 78. Interrogation techniques that have been approved and used at Guantánamo Bay, however, are not consistent with the objective of safe, legal, ethical and effective interrogations,122 and they have adversely affected the mental health of detainees. Further, the United Nations Principles and other codes of ethics for health professionals make no distinctions based on the role of the health professional. Their premise is that the knowledge and skills of health professionals should not be used to the detriment of humans; the particular position the professional holds therefore is not relevant.123 To the extent that health professionals “apply their knowledge and skills” to assist in any manner with interrogations that “may adversely affect” (emphasis added) the physical or mental health of the detainee, they violate professional ethics and the right to health of detainees.124 79. Reports from Guantánamo Bay confirm that doctors and other health professionals are participating in force-feeding detainees.125 The force-feeding of hunger strikers raises several distinct human rights issues. One issue concerns the manner in which detainees are force-fed, which is addressed in this report in the section on torture.126 Another issue concerns the ethics and legality of force-feeding, regardless of how it is undertaken, which the following remarks address only briefly given the severe space constraints. 80. The Declarations of Tokyo and Malta prohibit doctors from participating in force-feeding a detainee, provided the detainee is capable of understanding the consequences of refusing food.127 This position is informed by the fundamental principle, which recurs throughout human rights law, of individual autonomy. As well as the World Medical Association, the American Medical Association and many others have endorsed the Declaration of Tokyo.128 Additionally, during 2004, in the context of a hunger strike by Palestinian security detainees, the ICRC reported that its doctors will “urge the authorities not to subject detainees to force-feeding”.129 Further, some domestic courts have decided, based on an individual’s right to refuse medical treatment, that a State may not force-feed a prisoner.130 While some other domestic courts have taken a different position, it is not clear that they have all given due consideration to the relevant international standards.131 81. According to the United States Government, Department of Defense policy allows health professionals to force-feed a detainee in Guantánamo Bay when the hunger strike threatens his life or health.132 However, the United States policy is inconsistent with the principle of individual autonomy, the policy of the World Medical Association and the American Medical Association, as well as the position of ICRC doctors (as signalled in the previous paragraph), some domestic courts, and many others.