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Enforcing Medical Treatment to Keep a Person Alive: The Problematic Case of Anorexia Nervosa

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Guantanamo and Other Cases of Enforced Medical Treatment

Part of the book series: SpringerBriefs in Ethics ((BRIEFSETHIC))

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Abstract

In order to introduce the main problems present in debates over the [mis]use of enforced medical treatment, I will begin my specific analysis of controversial cases involving this issue by focusing on Anorexia Nervosa. The particularly controversial nature of the current way of dealing with Anorexia Nervosa stems from the question of whether or not we should consider anorexics autonomous enough to refuse medical treatment, given that Anorexia Nervosa is generally classified as a mental disorder.

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Notes

  1. 1.

    Sedgwick (1982), p. 4.

  2. 2.

    Certainly the Anti-psychiatric movement led by Thomas Szasz was very much in line with this idea, even though the bottom line was perhaps not to deny entirely the existence of some kind of dysfunction in the mind of certain people, the core revolution that the movement wanted to provoke was to stress the “mechanical” aspect of brain malfunction; i.e. it was curable with appropriate medicines rather than through the reassessment of the values of the individual.

  3. 3.

    A definitive assessment of when Eating Disorders emerged is not the remit of this work, and for reasons of simplicity I will accept the standard date of the 17th Century as the beginning of these kind illnesses. To understand the impact of such illnesses see: Kelly et al. (2009), pp. 97–103.

  4. 4.

    Not everyone agrees that Obesity is an Eating Disorder, but for a closer look at the current debate over this and other aspects of Eating Disorders see, amongst others: Fairburn and Brownell (2002); Palmer (2003), pp. 1–10.

  5. 5.

    Callahan (1998).

  6. 6.

    Di Paola and Garasic (2013), pp. 59–81.

  7. 7.

    Whether intentionally or not, it seems that a common critique of extreme consumerism is shared by Daniel Callahan and Michel Foucault. For reason of spaces the present investigation will not develop this connection any further, but for the purposes of this work, it will suffice to underline the role that consumerism has in medicine in contemporary Western society.

  8. 8.

    This is particularly true in the US, while not so evident in Europe –especially in Northern European countries such as Norway for example.

  9. 9.

    Ramsay et al. (1999), pp. 147–153; Franko et al. (2004), pp. 99–103.

  10. 10.

    Tan et al. (2003), p. 546.

  11. 11.

    Simona Giordano suggests in her book that this might instead have been William Gull. Giordano, Op.Cit., p.18.

  12. 12.

    Lasègue et al. (1873), pp. 265–266 and 367–369.

  13. 13.

    Selvini Palazzoli (1998).

  14. 14.

    Fichter and Krenn (2003), p. 369–383.

  15. 15.

    For example, in their report “Treatment Decision-Making in Anorexia Nervosa”, Jacinta Tan, Anne Stewart and Tony Hope reported an increase in the figure of male anorexics to 10 %. (p. 3) available at : http://www.psychiatricethics.org.uk/ANwebreport/report.pdf [accessed on 4 January 2015].

  16. 16.

    See amongst others: Kaplan and Woodside (1987), pp. 645–653, Carney et al. (2008), pp. 199–206, Tureka et al. (2000), pp. 1806–1810.

  17. 17.

    WHO (2015a). My emphasis.

  18. 18.

    WHO, International Classification of Diseases (ICD), ibid.

  19. 19.

    See, amongst others: Fairburn and Harrison (2003), pp. 407–416; Eating Disorders: Anorexia, Bulimia & Eating Disorder NOS (2015).

  20. 20.

    WHO, International Classification of Diseases (ICD), Op. Cit. My emphasis.

  21. 21.

    Giordano (2005), pp. 68–69.

  22. 22.

    Giodano, S., Op.Cit., p.70.

  23. 23.

    WHO (2015b).

  24. 24.

    Giordano, S., Op.Cit., pp. 30–31.

  25. 25.

    Szasz (1972).

  26. 26.

    Malson (1998), pp. 47–48.

  27. 27.

    In this respect it is interesting to note the different reaction that females and males have towards involuntary treatment. A good example of this distinction is Silber et al. (2004), pp. 415–418.

  28. 28.

    Szasz, T., The Myth of Mental Illness, Op. Cit.

  29. 29.

    Draper (2003), p. 4.

  30. 30.

    Dyer (2012), p. e4232.

  31. 31.

    Randall (1999), p. 127.

  32. 32.

    Giordano, S., Op.Cit., pp. 246–250.

  33. 33.

    See footnote 27 above and Robb et al. (2002), pp. 1347–1353.

  34. 34.

    Halse et al. (2005), pp. 264–272.

  35. 35.

    Carney (2009), pp. 41–59.

  36. 36.

    Here Carney refers to a specific term used in Australian contexts in relation to a third person (a guardian/tutor) deciding on behalf of the patient in question. Obviously, if the anorexic is found to be competent enough to make a decision, the guardianship remains with her.

  37. 37.

    Carney, T., Op.Cit., pp. 41–59.

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  1. The Edmond J. Safra Center for Ethics, Tel Aviv University, Tel Aviv, Israel

    Mirko Daniel Garasic

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Garasic, M.D. (2015). Enforcing Medical Treatment to Keep a Person Alive: The Problematic Case of Anorexia Nervosa. In: Guantanamo and Other Cases of Enforced Medical Treatment. SpringerBriefs in Ethics. Springer, Cham. https://doi.org/10.1007/978-3-319-22653-8_2

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