AL-OSHAN v. Obama, 753 F. Supp. 2d 1

Shalabi, a Guantanamo detainee, has conducted a hunger strike since August 2005 and was force-fed via nasal tube twice daily.
He has been hospitalized for about 18 months due to medical complications from the hunger strike, with concerns about constipation and rectal bleeding.
Past court orders authorized independent medical/psychiatric evaluations and limited others (ENT, GI) to assess and plan treatment, including competency considerations.
In May 2010 a GI endoscopy diagnosed gastroparesis, with weight around 100–104 pounds over six months and ongoing abdominal symptoms.
Shalabi seeks further independent evaluations by Dr. Keram and Dr. Crosby, calls for GI physician collaboration, and requests six-month follow-up visits.
The court cannot alter confinement conditions but may address health-related needs to ensure meaningful access to counsel; decision issued November 19, 2010.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether independent medical evaluation is warranted	Shalabi argues ongoing health risks threaten counsel access.	Government says habeas claims on conditions are not cognizable and no harm shown.	Partially grants; independent evaluations allowed to assess capacity.
Whether Crosby and Keram may travel to Guantanamo	Need direct in-person assessments to inform treatment.	Govt. disputes travel as unnecessary; claims no current denial of counsel access.	Granted for Crosby and Keram to evaluate on-site.
Whether the GI specialist should collaborate with Crosby	Joint evaluation for integrated treatment plan is necessary.	No explicit requirement for collaboration beyond prior orders.	Yes; GI physician to collaborate with Crosby.
Whether six-month follow-up visits should be authorized	Regular follow-ups are needed to prevent health crises affecting counsel access.	Uncertain future health; cannot order permanent change.	denied as permanent, granted as needed but not perpetual.

Bounds v. Smith, 430 U.S. 817 (1977) (meaningful access to counsel requires adequate inmate information and contact)
Husayn v. Gates, 588 F. Supp. 2d 7 (D.D.C. 2008) (independent medical examination when meaningful access to counsel is in doubt)
Omar v. Harvey, 514 F. Supp. 2d 74 (D.D.C. 2007) (staffing and health concerns impact access to counsel)
Al-Joudi v. Bush, 406 F. Supp. 2d 13 (D.D.C. 2005) (independent medical review when client’s ability to communicate is threatened)
In re Guantanamo Bay Detainee Litig., 570 F. Supp. 2d 13 (D.D.C. 2008) (context for medical evaluations and access in detainee litigation)
In re Guantanamo Bay Detainee Litig., 577 F. Supp. 2d 312 (D.D.C. 2008) (procedural framework for detainee health-related court orders)
Tumani v. Obama, 598 F. Supp. 2d 67 (D.D.C. 2009) (courts' limited ability to alter confinement conditions but address health concerns)