Forcefeed Anorexic patient?

[Zuckman]

Hey guys,

Just wondering, are doctor's obligated to force-feed anorexic patients when the patient is on the verge of dieing? What if the anorexic patient wants to die and she understands that she will die if she doesn't eat? In that case, she would be competent so a doc can't really ethically force-feed...not sure though...any input would be great.

 

Zuck

[Jewels1986]

I don't think an anorexic would be considered mentally competent - anorexia's a mental illness, and starvation causes very severe cognitive distortions, so they aren't really in a state to make such a decision. Many of them are also quite young, so their parents' wishes are important too.

[Rock*]

Just because a patient can be evaluated as incompetent in one area doesn't mean he/she is incompetent in all areas. The only way to find out if she's competent enough in making her treatment decision is to see if she understands the treatment options, the alternatives, and the consequences for each. If she understands that no treatment leads to death and that any depression she has now can be alleviated with medication and counselling and she still wants to die... you should still repeatedly bring up the question to make sure that she's consistent in her decision. If you're sure she's competent after all that, you should respect her autonomy and abide by her wishes.

[optimist]

Having had to forcefeed anorexic patients before, I can tell you that it is a terrbile situation for every single person involved.

 

If you consider the Mental Health Act, a physician/psychiatrist can force treatment on someone if they believe that the person is causing/likely to cause bodily harm to themselves or to others, or is neglecting/unable to care for themselves AND that the disorder is of a nature that could be treated with an intervention. Self-neglect, ie. not eating, counts as harm.

 

I am sure it is much easier legally to force a young person to eat than it would be an adult with no other underlying mental health issues. In older people, failure to thrive in the form of not eating is often seen as well. A physician or psychiatrist would have to be really sure that the individual was competent and making an informed decision.

[Zuckman]

What about a suicidal patient? I thought if a patient wanted to die that it is a docs obligation to hospitalize them against their will...since no competent patient would want to lose their life...

 

 

Zuck

[eise]

What about a suicidal patient? I thought if a patient wanted to die that it is a docs obligation to hospitalize them against their will...since no competent patient would want to lose their life...

 

 

Zuck

 

This is true. Suicidal patients can be formed against their will.

 

In most cases, anorexic patients are force fed against their will, often because they are deemed incompetent. I have not yet heard of a competent anorexic patient who denies treatment. I'm sure this is possible but most often they are depressed, have another mental illness, or have warped views as a result of the eating disorder.

[BigFace]

Hi

 

1) Distinguish between anorexia (loss of appetite) and anorexia nervosa (mental illness)....or other types of it.

 

2) Don't forget to consider the culture of illness/disease and diagnosis in your discussions. One culture may see anorexia nervosa as a mental illness where another culture (country) may not...doctors are supposed to be global thinkers!

 

All the above answers are great but they are generic...dont forget you guys are competing with several hundred people, be unique and stand out with your critical and globally positioned statements.

 

Good luck,

 

BigFace