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Force-feeding anorexics

Anorexia Nervosa is an eating disorder defined as severe, self- inflicted starvation and loss in body weight to at least 15% below that expected for the individual’s sex and height. In many countries, anorexia is classified as a mental illness. In normal cases, medical treatment cannot be administered without the permission of the patient, but in the case of mentally ill patients, altered perceptions of reality may render them incapable of making a reasoned choice.
Pros:
  • Anorexia is a mental illness. Patients are incapable of making a rational judgement.
  • Life is more important than dignity - the problem can only be solved as long as the patient is still alive, after all.
Cons:
  • Force-feeding is degrading - the patient's right to refuse treatment should be respected.
  • If an anorexia sufferer thinks that they will be force-fed they may be less likely to seek treatment or advice.
  • Compulsory treatment works in the short-term at best, and has associated risks of depression, which may lead to suicide.
 
Heh, interesting topic.

Grathea":1vqstspv said:
Life is more important than dignity - the problem can only be solved as long as the patient is still alive, after all.

Well, the only question is "To who?" Correct me if I am wrong, but is not the benefit to giving someone life in prison over the death sentence the fact that they have to live a life they do not want to as opposed to living no life? Would it be fair to give a metaphorical life in prison sentence to someone because they are mentally ill?

Force-Feeding Anorexics, though, that is an interesting idea. You could certainly consider them as being a danger to themselves, which would warrant protective custody which would warrant force-feeding. Logistically speaking, it's hard to argue against. I just think that there may be a bit more to the issue. I suppose if at the same time you are working to correct anorexia as opposed to counterbalancing it (forcefeeding does not treat anorexia, it just tips the scale) then it could work.
 
"Anorexia Nervosa is an eating disorder defined as severe, self- inflicted starvation and loss in body weight to at least 15% below that expected for the individual’s sex and height."

There are more symptoms of AN than just "self-starvation". AN sufferers also have severe Body Dysmorphia (a warped mental image of their own body compared to personal goals and ideals, and to the bodies of the people around them and images from the media) and a borderline to severe phobic fear of gaining weight. Plus, AN sufferers do not have to starve themselves to 'qualify' for diagnosis; laxatives, diuretics, binge-purge and excessive exercise are common methods of preventing weight gain employed by ANs. More extreme methods of weight gain have been noted as anywhere from taking up smoking to things as extreme as purposefully becoming hooked on crack cocaine and heroin simply because of the scrawny physique associated with smack'eads.

"Force-feeding is degrading - the patient's right to refuse treatment should be respected."

Whether something is degrading or not is subjective; no, you wouldn't like it if it were happening to you, but a patient's circumstances differ from yours entirely. If a treatment is necessary, works, and is carried out in a private and discreet environment, the argument for it being degrading looks like nothing compared to the chance of curing or improving a patient's condition. Plenty of treatments used to deal with psychological disorders could be considered degrading; insulin coma therapy (though it's not used any more), narcotherapy, electro-convulsive threapy, aversion therapy and interoceptive exposure are all used to cure people of disorders and they work. The (sometimes compulsory) rehabilitation process for certain drugs is horrible; vomiting, convulsions, hysteria, hallucinations, you get the whole package, yet people will say "damn right s/he got bunged in rehab, it's for their own good". Being forced into such a painful process could be considered degrading, yet almost every normal person you ask will be on favour of it because they do not see far enough past the problem to see the crippling process that the cure entails. Saying "waaah it's degrading" is a weak and pointless argument that is easily tossed aside.

"If an anorexia sufferer thinks that they will be force-fed they may be less likely to seek treatment or advice."

If an AN sufferer seriously endangers their own life through their body-warping methods, they may not be given a choice in whether or not they receive treatment. If a patient accepts and acknowledges the fact they have AN, they are in fact incredibly likely to seek treatment and support.

"Compulsory treatment works in the short-term at best, and has associated risks of depression, which may lead to suicide."

Nothing stops at "compulsory treatment" because otherwise there would be no point. A patient suffering any type of mental disorder is treated and continually even after the compulsory actions have been administered. Until someone is given a completely clean bill of mental health, they are helped and encouraged in every possible manner to aid in their recovery.
 
Holly":4x30mo76 said:
Saying "waaah it's degrading" is a weak and pointless argument that is easily tossed aside.

Well, actually this is a purely emotional argument. There is no way to prove, using facts, that it is better to live ashamed than die proud. I mean, I personally would rather live but why do we get to force someone else to live who doesn't want to?
 

Jason

Awesome Bro

DeM0nFiRe":3t37brqz said:
Holly":3t37brqz said:
Saying "waaah it's degrading" is a weak and pointless argument that is easily tossed aside.

Well, actually this is a purely emotional argument. There is no way to prove, using facts, that it is better to live ashamed than die proud. I mean, I personally would rather live but why do we get to force someone else to live who doesn't want to?

Like I heard on some movie, forgot which...

"You only get one chance at life... don't fuck it up"
 
DeM0nFiRe":9oaau2e5 said:
Holly":9oaau2e5 said:
Saying "waaah it's degrading" is a weak and pointless argument that is easily tossed aside.

Well, actually this is a purely emotional argument. There is no way to prove, using facts, that it is better to live ashamed than die proud. I mean, I personally would rather live but why do we get to force someone else to live who doesn't want to?

First, most people will agree that it's better to live ashamed than die in general, and that life is precious. Everybody would like to die with pride, but to pass up a chance at life in order to die proud is irrational. For example, someone has a choice; their mother is out for the count and will die without life support. They have to decide between switching her off and leaving her plugged in. Most people, as long as they can afford it if they have to (lolamerica), choose to prolong the person's life in the off-chance that they recover rather than give up. The same can be applied here; would you let someone kill themselves with their backwards habits, or intervene and give them help (without choice, if necessary) so that they have the chance to do something with their lives? Yes, this is a subjective subject, but subjective data can (and in this case, has) been objectified (i.e. there are facts).

Second, you're assuming that being forced into treatment that works (albeit slowly) results in shame at the end of it. Recovered AN patients that I've talked to are all quite proud of the fact that they've overcome it, and strive to spend their lives helping other people with their condition. Even if we assume that at least some patients will be ashamed of being forced into treatment, they will get over it. Shame is fleeting; the human mind works to protect itself and while someone may never forget painful things, they will not always be there itching and poking at them and causing them bother.
 
Shame is fleeting for most people, but not for everybody. You can't make Mike live a certain way just because Joe and Bob would want to live that way. It is completely irrational to assume our own way of life is the way of life everybody should be ok with. It isn't up to us to decide if someone else should live under certain conditions they don't want to live under.
 
If an adult wants to kill/ruin themselves then either let them or try to council them against it. It is no one's right to forcibly take away someone else's right to destroy themselves. It is their body to destroy, and that should be an inalienable right in any society.

If a teen/child wants to hurt themselves ... Well, that's up to their parent/guardian to call the shots.

But insofar as adults go, we should have the freedom to do to ourselves as we will, as long as it is not actually hurting anyone else or infringing on their rights.


If some asshole officially decided to tell me I couldn't get a tattoo because it causes skin damage, or that I couldn't eat a hamburger because it causes artery blockage, I'd move to another country. Same goes for if I wanted to stop eating. It's my fuckin choice.
 
Yes, it should be an inalienable right to do whatever you wish with your body, and up until someone decides otherwise, it is. Once someone notices any self-destructive behaviour patterns, you can be deemed incapable of making the decision to take treatment and be forced into care. Any reasonably close member of your family or even an appointed social worker can forward you for treatment; there has to be two agreeing medical opinions to detain someone, but with that you can simply be taken away simply for being a danger to yourself. A teen/child would be treated exactly the same.

You can't compare tattoos and burgers to anorexia or any other mental illness because they're certainly not on the same level. Nobody will tell you that you can't have a tattoo or a burger because they're not guaranteed to damage your body; they can (and do) say that you shouldn't have them excessively because of the health risks associated with them because in excess they do have the potential to threaten a person's physical wellbeing. Getting a tattoo or eating a burger are everyday decisions made by thousands, if not millions of people each day, no anorexic simply decides "I won't eat today". To an anorexic, the various methods for losing weight are all about controlling their body image, and to many, voluntary treatment means giving up the control that they've reigned over their body for months, if not years. When they refuse to seek treatment because they cannot or will not accept that what they're doing to their body is extremely harmful, then it's time for medical intervention.

Yes, it is your right to choose what to do with your body, but you also have the right to have access to any and all necessary medical treatments, which is much more important. The judgement of many mentally ill people is impaired and they will not seek help with their condition, so it is up to a medical practitioner to decide.
 
I have only actually met one anorexic with a true mental disorder. Most simply do it for attention. It was actually the "in" thing to do when I was in early highschool. And these girls weren't crazy, they were just making stupid decisions with too much willpower.

I would say that an actual psych evaluation should precede any sort of forced actions. And a patient would take better to mental therapy/counseling than forced feeding, in the long-term, unless they are already on their deathbed (though the ones that do it for attention likely wouldn't get to that point). In the extraordinary circumstance of a severe mental instability or disability (in which the patient has been baker-acted or rendered incapable of making any sound decision), however, I agree that it's the hopsital's prerogative to maintain life.

However mental health illnesses are a far touchier subject than others. Even today we've made little progress on knowledge of the actual causes and effects of non-physical stimuli on the brain. If a person acts perfectly normal, but they refrain from eating because of some unknown reason, then it may not be an actual illness at all, but rather a subconscious (or even conscious!) choice. And who determines what is a disability and what is a choice? It's a very grey area.

It's my personal opinion that therapy should always be the first option for anything, and it SHOULD be made much more widely available and accepted. If you love someone who is hurting themselves then you need to take steps to cure them, not to provide a quick fix, and before they get to the point where you have to make a life-saving decision for them at all. With mental health, a typical PHYSICAL health doctor has no definable place.
 
Anyone who does it for attention is not anorexic and will rarely actually get to the point where they could endanger their lives.

Maybe I shouldn't have said "medical", but I lump physical and mental health together because they're both quite important (and also the NHS here covers both so). Of course psychological evaluation and therapy are intrinsic to the treatment given to anorexics and most mental illnesses. The act of "force feeding" in it's purest sense is actually rarely used (like you say, on a deathbed they may be literally force-fed, but by that point they are oten too weak to fully complete the process of eating and digestion, and have to be put on a drip). Rather, they are encouraged to prepare and eat small portions of high calorie foods (since most anorexics do in fact eat; rather than starve themselves they use other methods of control to govern their weight and such), gradually increasing the portion size and educating them about nutrition and their body's requirements. Anorexics in care are often grouped together and go through the process of breaking bad habits and thought patterns together to help the process.
 
Well, there are some interesting stories written as satire to points like this. I would recommend you read some of them, "Harrison Bergeron" by Kurt Vonnegut is a good one. Basically, they all look at definitions of words we use a lot like, for instance, a danger to oneself. Someone who eats a lot of fast food is a danger to themselves, so should they be deemed unable to make their own decisions?

Basically, Psychology is a very iffy field, and there's not much about it that is known for sure. As soon as someone comes up with anything that sounds like it may be reasonable, everyone just seems to run with the idea *cough* Freud *cough*. So it's kind of hard to deem someone mentally ill if all they do is under-eat. They don't do the same thing to people who over-eat.
 
No, Psychology is definitely an iffy field, and the theories accepted today have only been around for the past 40 years or so. We are only as sure of these theories as people were sure that demons and spirits controlled personalities for thousands of years before the current theories. Even the people who practice the theories will tell you that they are just that-- theories.

And why isn't the burger a valid point? There are people who very clearly lack the ability to control themselves when they are over eating and eventually kill themselves. In any case, the problem with eating too much is certainly not as severe as eating too little, but where do you draw the line? If you compare the two, they are certainly similar.

Along the same lines, why are cigarettes not banned? Do people addicted to cigarettes have control over their addiction? Anorexia is a psychological addiction to dieting, because sufferers believe that dieting will solve what they feel causes their insecurities. (Now, I use the term "believe" sort of loosely, as it's a sub-conscious thought, not them literally thinking "Hey, This will make me feel better!")
 
People who overeat fast food is what I said the first time. They lack the control to keep themselves from over eating.

As for psychology being an iffy field, comparing it to something "tried and tested and known to work" is ridiculous. Who in their right mind thinks that we fully understand the workings of the mind. 40 years in psychology is not comparable to the year or two it takes to prove that a physical remedy for a physical problem will work.

As for Frued, he certainly contributed greatly to the ideas behind psychoanalysis, however his specific theories are ridiculous. The only possible way his theories make sense is if you work backwards, and start with his conclusions. I don't discredit Frued because his theories were perverse, but because there is no real logic behind them. I've read his theories, and they all ignore the external variables that can very easily (and much more likely than his theories) explain the conclusions.
 

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