Anorexic woman to be force fed

[Empusa]

Article

I'm not sure what I think of this, it's such an awful situation. :(

This is undoubtedly going to be a very difficult and contentious thread.

My own view is that if someone had a mental illness that might cause them to harm themselves then it would be the right thing to protect them until they could be treated.

Should anorexia be treated as a a mental health condition?

Should someone who over eats to the point of reaching a life threatening weight be forced to starve?

Anorexia is a mental health condition. Most hospitals have a ward that takes anorexics under section for feeding via an NG tube. The patient has no say in the feeding, if they pull out the tube it is reinserted.

This is going

Posted too soon. Difficult topic as yes a mental health issue, it is a control issue, and if the person loosed all control all that will happen in a later relapse is the patients won't go near anyone in mh.

I used to nurse patients with anorexia. It's so hard trying to help when they don't want it. Unfortunately, anorexia can cause severe imbalances in the brain's chemicals, which affects thinking very much. Everything is black or white, no in between like other people. Most of us have no chemical imbalance this severe, and we are able to compromise, but most people with anorexia are unable to do this.

Occasionally judgements are made in the person's best interests, based on how they would be if their brain was healthy and balanced. Maybe that's the case here. It seems unkind to stop them dying if that's what they want, but from a health professional's point of view it's 'first do no harm'.

Personally, I think if she wants to die, she should be allowed to, this is her choice. Unfortunately, a few people in positions of power feel otherwise.

This is a desperately sad situation where frankly, there is no right or wrong.

I dont understand it at all. If a disabled person wishes to end their life they are postively encouraged. Right to die n all that. Why cant this woman starve herself if she wishes.
And yes, I was an anorexic so I do understand the illness.

My best friend died from anorexia 5 years ago and she was only 23. There were times when it would have seemed a good option to knock her out and feed her through a tube until she was a healthy weight and somehow force her to think straight, but realistically it wasn't going to happen and any recovery had to come from her wanting to recover and family and friends supporting her as well as the medical profession.

I think not enough is understood about anorexia and other eating disorders. I think until more is known it is hard if not impossible to treat. The key seems to be catching it early.

This isn't so much about Anorexia, as the woman being found to 'lack capacity', using the Mental Capacity Act. This is applied to all service users when deciding treatment or planning for care.

The woman had a living will that stated that she wanted to be revived and kept alive, so that stands whilst she is unable to over rule that, as it should.

"Why cant this woman starve herself if she wishes"

Using the format of the MCA, it has been established that she is unable to state her wishes, given her MH state, taken into account of her living will, they have decided that the ethical thing to do is to treat her.

Families cannot be given that power, if the person has a living will.

This is applied toall treatments,as you can temporarily lack capacity as a reaction to perscribed drugs/trauma/or your illness.

This is such a sad story.

i don't know what to think TBH.
I kind of feel that if the woman wants to die and her family and the people treating her think she should be allowed to then I'm not sure where the objection comes in.

Having said that i have a friend with an anorexi DD and she told me about how having so little nutrition can cause the imbalance in the brain todaysagoodday speaks of.

But still I think that fundamentally people need to be allowed to end their own lives if that is their wish.

"I kind of feel that if the woman wants to die"

If you read through the article, it has been stated that she doesn't want to die, but cannot eat, she isn't conecting the not eating with death and her living will stated this, she wants intervention.

The Mental Capacity Act is the deciding factor.

I did read the article.
First she said she wanted to die.
Then she said she didn't.
Which was the statement made when she was thinking straight? Not knowing when she made them, I wouldn't like to guess.
Everyone around her thinks it's time to let nature take its course.

This makes me so sad. Anorexia is such an awful condition.

Anorexia sufferers in clinics are put on very strict feeding regimes because one successful treatment for the mental/chemical imbalances is nourishment. It's a vicious circle otherwise. Force-feeding may get her to a point where she regains her mental capacity. There has to be some disagreement between those responsible for her care and/or her family for this to have come to court. Sad cases, always.

What is the prognosis if they do forcefeed her back to an almost healthy weight? Is she likely to recover competency or a sane attitude towards her body & food?

Some find an intensive programme of nutrition leads to the self-preservation instinct kicking back in and recovery. I've heard of it being described as a 'fog lifting'. Others relapse and never recover. The patient wouldn't be force-fed to a healthy weight. Just out of the danger zone, I expect.

"What is the prognosis if they do forcefeed her back to an almost healthy weight"

The court have found that there could be a good chance that she will get well, because she will now qualify for help that she previously didn't.

This isn't straight forward Anorexia, as such, she has had alcohol problems since she was 11 and other possible MH, problems in the past.

She was a medical student and very intelligent.

I'm so torn on this.

On one hand, I understand the duty of care and that she has no hope of recovery unless she starts eating.

On the other hand, the experience will be brutal for her and does not guarantee she won't relapse. In fact, I can imagine it is equally likely to sour her relationship with food and eating even further. Recovery involves far more than eating a few meals. How long would she be force fed for?

The full details of the judgement are linked to here

The proposed treatment plan involves a bit more than eating a few meals.

This was obviously a hugely difficult decision for everyone involved, and the timing of the application to court is appalling. IMO.

Ultimately once it was determined that this woman lacked capacity then the judge had to determine where her best interests lay, and he has come down on the side of active treatment.

I'm presuming that given that this has been published that the judgement was accepted and an appeal not made against it. The process of transfer and PEG must have been horrendous for her and her family.

You can treat anorexia, but it is more successful if caught early. My dd had it very badly, and was in a unit for 8 months. She was very resistant to treatment and desperately wanted to be left alone. She is now a fit, happy, successful girl who wants to forget she was ever ill.

And it most definitely is a mental illness, and the treatment is food. Cognitively, they are all over the place until they can get some decent nutrition. Its a vicious circle. Unfortunately, this person has had it for a long time and it will be very entrenched behaviour.

The prognosis with anorexia is 33:33:33. A third recover, a third struggle and a third don't get better.

I wonder how long she was on the pallative pathway and who decided that they needed to seek legal guidance ?
Did it say she was going to be treated by PEG ? i would of thought NG feeding was the first course , she is likely to pull it out , but she could just as easliy pull a PEG out and cause alot more damage.
I think that once they are able to get her so that her decision cannot be blamed on electrolyte imbalance , then they need to check what she does want and get her to revise her living will .

I wonder if this case might have been viewed differently if the patient were a man? I wonder if the medical profession, and the courts, society in general, are quicker to label a woman as being of unsound mind than a man. In the same was that historically women were often diagnosed with "hysterical" illnesses (literally considered to be caused by the uterus). Women, who so often are not listened to and are disempowered, have historically used "hunger strike" as a way of expressing themselves. Think of the Suffragettes. Force feeding was used in prison, and many of those women suffered long term physical harm. I know the situation and the methods were different. But I do believe that even in this sad case, force feeding represents the removal of this woman's autonomy, right to express herself and a violation of her body. It in my mind is like trying to cure a person with sexual dysfunction (again, a mental condition with physical manifestations) by raping them.

So sad. I'm a recoverred anorexic, and the sheer terror of being force fed would've made me kill myself another, quicker way.

I hope that poor woman and her family find peace in whatever they do.

feelingpositivemum we were told the same thing about thirds (phoenix centre) and I think a few years later I see it playing out that way

I don't understand why this is news but think, as frumpet says, they can't forcefeed for long and the woman needs to make these wishes clearer as soon as she is able