Columns

Should We Force-feed Anorexics?

Nick Gavey argues that we should; Oliver Dickie disagrees.

 
 
Nick:
Anorexia nervosa is a serious mental illness, like depression or bipolar disorder. In most cases it can be treated with a combination of therapy and medication. But not always. There are, and will continue to be, cases where anorexics starve themselves to death. In this minority of cases, medical professionals are justified in force-feeding anorexics.
For someone who has starved themselves to the brink of death, food is obviously a medical necessity. The crucial issue is whether people suffering from anorexia should have the right to refuse medical care. You could easily argue that even a sane, rational person shouldn’t be allowed to starve themselves to death. For example, many countries around the world will force-feed prisoners of war if they choose to protest through a hunger strike. There is a fair argument to be made that as a society, we value life so much that people shouldn’t have the right or the freedom to give up their own lives.
But even if you do support this right – even if you think protestors should be allowed to starve themselves to death to make a point, even if you believe in the right of the terminally ill to have access to euthanasia – this still doesn’t mean that sufferers of anorexia should be allowed to starve themselves to death. The right to refuse medical treatment, or food, or anything life-sustaining has to be premised on the decision being made by a rational person. There is no way that a person whose anorexia is so severe that someone who has put their own life in danger is capable of making such a choice. Western society has long recognised that sometimes mentally ill people do need to be treated against their will. The right to refuse medical care cannot apply to a malnourished waif who is convinced she is obese.
Force-feeding anorexics does not cure their mental illness. That isn’t the point. If an anorexic person has starved themselves to the point where their life is in danger, the most pressing medical necessity is their severe malnutrition. Food, voluntary or not, gives doctors a chance to address the root cause of the behaviour. 
It is wrong to allow a mentally ill person to kill themself. This applies across a whole range of severe mental illnesses. To oppose the force-feeding of anorexics, one must support allowing a mentally ill people to starve his or herself quite literally, to death. No moral person should support such a conclusion.
 
Oliver: 
The idea of force-feeding sufferers of anorexia is not only immoral, but is an invasion of an individual’s autonomy, and in no way helps determine a solution to the issue. 
The argument that force-feeding is only a short-term solution fails to take into account the long-term effects treatment of this kind will have. Anorexia is something that can rarely be cured with pills. In the majority of cases it will require long-term counselling, and that will require a high degree of trust. The force-feeding of those who suffer from anorexia is going to see a collapse of this trust. How can a person trust a system that claims to be trying to help them, when against their will, it forces a tube down their throat?
The effects of this practice will be to encourage a yoyo effect that is already experienced by many with weight problems. A patient will simply gain weight from force feeding, then lose it again, due to the now permanent lack of trust they will have for the system.
On top of this we only have to imagine the psycholigical side effects a practice such as this would have on the patient. In the majority of cases anorexia can be classified as a mental disorder where an individual has a distorted image of their bodies. Forcing a tube down the throat of someone whose mental health is already in question is simply going to force this person further from reality and a path to recovery. 
Finally, who has the right to decide that a person can no longer choose for themselves, and instead takes away their autonomy, and makes their decisions for them? We can provide counselling and information on the issue and its dangers, but to take away the independence of a person who is a danger to no one but themself is immoral and inconsistent with so many aspects of our society. Proportionally, more people die of obesity than anorexia, but there is no policy on limiting meal sizes, which would have far few psychological effects.
 
Debatable is a column written by the Otago University Debating Society. They meet every Tuesday at 7pm in Commerce 2.20.