Jacob Williamson responds to our reader:
What about those that refuse conventional, certified-effective medicine and instead opt for homeopathy? Again, I take it as irrelevant that there could be some hidden benefits to this form of treatment. Even if we were sure it does nothing, so that the person would be acting on a false belief detrimental to their health, thereby being irrational and allegedly lacking autonomy – would we even consider coercing them? What about the man who dies waiting under the illusion that God will intervene and save him? I’m yet to understand why anorexia should be so different.
Another reader jumps in:
I have to take issue with what your last reader said: "If force feeding anorexics is wrong, then so is forcibly committing someone who is suicidal to an institution to protect them from themselves. To say it is wrong is to assume the person is capable of rational decision-making." This misses the complexity of the issue. My girlfriend has had a history of emotional issues and depression, and nearly a decade ago she had an episode involving a therapist committing her to a psychiatric ward for allegedly being seriously suicidal.
This was after only a couple of months of regular therapy (so, about 8-10 sessions), and the therapist made this decision against her wishes. She was then forced to commit herself in order to defend her free will. She managed to suffer two nights before anxiety attacks demanded she check herself out Against Medical Advice. There are two effects from this episode:
1) She, in fact, did not kill herself.
2) She is deathly afraid of conventional therapy and psychology. If it involves human interaction on an emotional scale, she will not go. Yet she needs it because she's still emotionally unstable.Forcing a cognizant person to undergo forced treatment, especially treatment that is demeaning, will damage the chances that the patient will continue constructive, often-necessary therapy in the future. Like my girlfriend, this could leave a patient continuing to fear for their own emotional state, but also fearing sincere attempts to help and soothe fears, leading down an even darker road of despair.
I understand the belief that "if she cannot act to preserve herself, then we must forcefully act to preserve her" is common sense, but it is not good sense. Often a person's emotional state is fluctuating too wildly to make definite predictions of behavior, yet we should be rather certain of a patient's situation before we commit the grave act of eliminating the person's freedom. In the courts, we believe we should be biased towards the freedom of the defendant. For some sad reason there are no such biases for those more pitiable than your average court defendant.
Some people have trouble stomaching the idea that a broken person has the free will to kill himself. I am not one of them. What good is free will if you cannot act on it in a manner that is contrary to the wishes of those around you? No one ever said that freedom's extreme acts should only produce things the censors approve of.
As for my girlfriend, I will keep pushing for the therapy she needs. But I will defend her to the limits to keep her from being unjustly restrained by singular people making autocratic decrees. Because that will be the death of her spirit.
The Dish 