The handling of hunger strikes by one Washington State inmate during 1983-1985 illustrates the issues involved. That case was resolved when a special commission examined the problem and recommended a policy for its management. The inmate has voluntarily maintained sufficient food intake since the policy took effect. The basic conflict related to the hunger-striking inmate is between the individual's right to privacy and the State's compelling interest in maintaining its own rights, such as orderly prison administration. A hunger strike ultimately produces physical consequences requiring medical attention. Prison authorities have only two choices: do nothing and allow the prisoner to die or force feed the inmate. Different societies have dealt with the problem in differing ways. Great Britain gives the attending physician the responsibility for making the decision. France allows the prisoner to refuse nourishment until the prisoner's life is endangered, when the physician is obligated by law to treat. Canada requires the force-feeding of hunger-striking inmates. United States law is evolving to the same conclusion as Canada. The bulk of experience in the Western world goes against the mandate of the World Medical Association Declaration of Tokyo, which condemns the force-feeding of hunger strikers. Discussion of the clinical course of starvation, 39 references, and an appendix presenting the Washington State policy and procedure.