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Speaking at a White House press conference Tuesday, President Obama was blunt about his administration鈥檚 decision to force feed hunger strikers at the Guant谩namo Bay military prison in Cuba. 聽

鈥淚 don鈥檛 want these individuals to die,鈥� he told reporters.

But those incisive words belie the complex moral quandary the US faces over the latest hunger strike, which has escalated since its inception in February to include some 100 of the 166 terrorism suspects held at the prison. Nearly two dozen are now being force fed a nutritional supplement through tubes inserted in their noses 鈥� a move that the American Medical Association told Secretary of Defense Chuck Hagel 鈥� of the medical profession.鈥�

By many accounts, the Obama administration faces a grim choice in the hunger strike case. Force feed strikers and you violate the accepted medical teaching that competent adults have the right to refuse medical treatment. Let the strike continue, however, and the participants could force their demands to be met, or die and become heroes for their cause.听

鈥淭he truth of the matter is that most hunger strikers don鈥檛 die, but it鈥檚 not because they鈥檙e not willing to,鈥� says George Annas, a professor of health law, bioethics and human rights at Boston University. 鈥淚t鈥檚 because the people watching will do almost anything to keep them alive. That shows how powerful of a weapon this is.鈥澛�

The question of how to manage a prison hunger strike is not a new one. The Bush administration wrestled with the very same question at Guant谩namo in 2005 and 2006.

More broadly, hunger strikes have proven a uniquely visceral and emotive form of protest around the world 鈥� and how other cases have been handled may provide important clues for the Obama administration鈥檚 choices at Guant谩namo.

鈥淵ou hear American officials say again and again, 鈥榳e don鈥檛 want another Bobby Sands,鈥� 鈥� Dr. Annas says, referring to an Irish nationalist who died in prison after a 66-day hunger strike in 1981, during the Irish Republican Army's battle against British rule in Northern Ireland. The death of Mr. Sands and nine others in the prison provoked a surge in membership for the IRA and sparked international outrage, as did the hard line British Prime Minister Margaret Thatcher took against their action.

鈥淢r. Sands was a convicted criminal,鈥� she said just after his death. 鈥淗e chose to take his own life.鈥�

Since then, however, the British prison system has not had a single death during a hunger strike, Annas says, despite a policy of never force feeding. Instead, the British have largely adhered to international medical dictates on hunger strikes, which call for prisons to bring in independent physicians to monitor strikers and advise them on their health and safety.听

鈥淭he physician is in an ideal position ... to try to find a compromise solution, calm everyone down, and ultimately defuse the conflictual situation,鈥� earlier this year.

Under US law, too, most prisoners on hunger strikes are allowed to consult with a doctor from outside the penal system. But Guant谩namo exists in a separate and far murkier legal space, where the guidelines used for prisoner treatment elsewhere have frequently been shunted aside by concerns about terrorism and American security.

鈥淭here are two magical phrases that motivate a great deal of American policy: 鈥榳e have to do this for national security鈥� and 鈥榳e have to do this to save lives,鈥欌�� Annas says. 鈥淎nd in the case of [Guant谩namo] hunger strikes, you have the administration putting those two together: 鈥榳e have to save lives for national security.鈥� That鈥檚 an extremely powerful argument on an emotional level.鈥�

Israel and Palestinians

The question of how to deal with hunger strikers whose release or death may pose a diplomatic or security threat has also touched off massive controversy in Israel, which holds thousands of Palestinians behind bars in 鈥渁dministrative detention,鈥� or incarceration without charge.

Those prisoners have launched more than a dozen hunger strikes since 1968, including a 2004 strike in which nearly every Palestinian held in an Israeli jail participated, , reported The New York Times.

In recent years, however, social media has helped carry the message of such strikes further, and focused broad international attention on Israel鈥檚 two-tiered prison system. Since 2011, a series of strikes known as the 鈥渆mpty stomach campaign鈥� has succeeded in winning the early release of several prisoners, including one .听

At Guant谩namo, too, activists hope that the intense emotional resonance of the hunger strike will force the administration to act on behalf of the remaining prisoners, half of whom have already been cleared for release.

鈥淭here is no end in sight to our imprisonment. Denying ourselves food and risking death every day is the choice we have made,鈥� wrote , a Yemeni prisoner who has been held at Guant谩namo for nearly 11 years, in an April 14 opinion piece in The New York Times. 鈥淚 just hope that because of the pain we are suffering, the eyes of the world will once again look to Guant谩namo before it is too late.鈥�

The case of Irom Chanu Sharmila

But simply drawing the world鈥檚 eyes 鈥� and ire 鈥� is not always enough to make a hunger strike successful.

Take the case of Irom Chanu Sharmila, an Indian political rights activist who has refused food and water since November 2000 in protest against a law that shields the military from prosecution in the region of northeast India where she lives.

Every two weeks since then, Ms. Sharmila has been hauled before a judge, feeding tube dangling from her nose, to ask if she is ready to end her fast. Every two weeks, she has said no.

The 500-week hunger strike has drawn small blitzes of media attention over the past decade, but has largely faded from public consciousness in recent years 鈥� even as its Sharmila quietly endures.

鈥淯ntil and unless my demand is fulfilled, I will be passing my life in this way,鈥� in 2011. 鈥淭here is no other way.鈥�