A political prisoner on a prolonged hunger strike refuses all food but continues to take water and electrolytes. Based on documented survival data in starvation, death would be expected once his body mass index falls below approximately:

• A 16 kg per square meter
• B 18.5 kg per square meter
• C 13 kg per square meter
• D 11 kg per square meter ✓

Explanation

Forensic and clinical literature on hunger strikes records that a body mass index below about 11 kg per square meter is incompatible with life, and force feeding debates use this threshold. A BMI of 18.5 marks the lower limit of normal nutrition, and 16 defines moderate thinness, both compatible with survival. The value of 13 represents severe wasting but is still survivable in monitored prisoners receiving water.

Reference: Knight's Forensic Pathology, 4th ed.

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Written and medically reviewed by the StethoPrep medical team.