Eating Disorders - Research Paper Example

Eating Disorders One of the most worrying disorders in the modern health industry is the problem of overweight or obesity, and we are living in a culture which puts too much emphasis on thinness as it is regarded as the basic component of physical attractiveness, success, and happiness of modern man. People in the recent years place great importance to their weight and body shape which determine self-image for them. The physicians and health-care professionals in the contemporary world also emphasize the diminution of obesity and the control of eating disorders. One of the most controversial methods of treatment of eating disorders or Anorexia Nervosa in the contemporary medical practice has been Compulsory (Involuntary) and Coercion treatment which concentrates on forcing the victims of Anorexia Nervosa to submit to treatments against their will. Significantly, the compulsory treatment of anorexia nervosa has been a debatable practice because there have been research evidences favoring as well as contending the method and its effectiveness. In fact, medicine and ethics have been the dominant players determining if and when coercion is appropriately employed in the treatment of health condition and, according to Stephen W Touyz and Terry Carney, “the same is true of anorexia nervosa (AN), where the medical and ethical debates are arguably even more contested than in the case of involuntary mental health treatment, which itself generates very lively debate.” (Touyz and Carney, 212) Therefore, Compulsory (Involuntary) and Coercion treatment invites more in-depth and focused to studies in order to determine whether this method of treatment of anorexia nervosa is effective or not. Some of the most recent studies on this contentious topic report that the Compulsory and Coercion treatments have been greatly effective in dealing with the eating disorders. Similarly, it has been reported that the people who are given life-sustaining treatments for anorexia nervosa without their consent have later changed their attitude to express their goodwill towards their care providers. In a reflective exploration of the topic, it becomes lucid that Compulsory and Coercion treatments are necessary in order to stabilize the mental disorder of a victim of Anorexia Nervosa, save their lives, and treat the disorder in such way that there is no possibility that the victim will suffer from Anorexia Nervosa again. Compulsory and Coercion treatment, which forces the victims of Anorexia Nervosa to submit to treatments against their will, has invited severe criticisms in the health-care sector as some of the research evidences suggests that there are several drawbacks connected with this method. Anorexia nervosa is one of the most prominent and common specific forms eating disorders in the United States and it is characterized by rejection of the maintenance of a healthy body weight due to an obsessive fear of overweight. Although effective treatment of this eating disorder is essential, the use of treatment without consent is generally regarded litigious in the context of anorexia nervosa, mainly based on the questions of efficacy and ethics. According to some research findings, compulsory treatments are more damaging to the victim’s psychological problems that are linked with Anorexia Nervosa. There have been criticisms against compulsory and coercion treatment based on its efficacy and one common argument in this regard is that it is difficult, if not impossible, to engage patients in psychological therapies without their consent. (Dresser, 1984) Similarly, it has been found that compulsory and coercion treatment to disinclined patients will not be effective in the long run although it may serve short term purposes. (Rathner, 1998) It has also been reported that compulsory and coercion treatments make victims feel worse about themselves instead of making them feel better. Thus, there have been several criticisms against the efficacy of the compulsory and coercion treatments in the context of anorexia nervosa. However, as Dr. Jacinta O. A. Tan, et al maintain, “even if the efficacy of compulsory treatment is demonstrated, there remains the ethical issue as to whether or in what circumstances it is justifiable to impose compulsory treatment for patients with anorexia nervosa.” (Tan, et al, 269) Significantly, many compulsory treatments are practiced illegally, in some part, by forcing the victim to be treated even against their will. In spite of the criticisms based on the efficacy and ethics of compulsory and coercion treatment, most recent research findings suggest that this method is highly desirable because it stabilizes the mental disorder of victims. Significantly, there have been several research findings in the recent years which suggest that the Compulsory and Coercion treatment stabilizes the mental disorder of victims. Thus, a recent study conducted by Watson and others report that the patients who were given life-sustaining treatment for Anorexia Nervosa against their will later expressed goodwill towards their care providers. (Watson, et al., 2000) Therefore, one of the main arguments in favor of enforced treatment of anorexia nervosa is that it alleviates the mental disorder of the victims and it can be life saving in the short term. Opposing sources state that compulsory treatments may be damaging to the victims psychological problems that are linked with anorexia nervosa. As R.L. Palmer purports, Compulsory and Coercion treatments are unacceptable because the involuntary patients are more likely to become depressed and commit suicide when discharged. (Palmer, 1980) The other major reasons for not implementing compulsory treatment provided by the opponents of this treatment are listed by Griffiths and Russell. Accordingly, compulsory treatment of anorexia nervosa contravenes the rights and autonomy of the patients and there is a lack of evidence to prove the effectiveness of compulsory treatment in the long term. Similarly, “compulsory treatment destroys trust in the therapists and team, erodes the therapeutic relationship and undermines the likelihood of other treatment … [and] a power struggle with the therapist may develop which is counterproductive.” (Griffiths and Russell, 131) However, it is reported by several research evidences in the area that compulsory treatments help save the lives of Anorexia Nervosa victims. Thus, Jacinta O.A. Tan and others, in one of the most recent studies on the topic titled “Attitudes of patients with anorexia nervosa to compulsory treatment and coercion”, conclude that “people with anorexia nervosa appear to agree with the necessity of compulsory treatment in order to save life. The perception of coercion is complex and not necessarily related to the degree of restriction of freedom.” (Tan, et al, 19) Therefore, it is fundamental to realize that, in literature, the most essential reason given for the necessity of compulsory treatment has been to save the patient’s life due to low weight and to cancel out the effects of starvation which distort the patient’s ability to make treatment decision. Similarly, compulsory treatment is recommended as a means to ensure that the clinicians are able to safeguard the health and safety of the patient and to “demonstrate the clinician’s devotion to the patient.” (Yager, 376) Similarly, it is argued that the reasons for not implementing compulsory treatment as provided by the opponents of this practice lack definite evidences, whereas the arguments in favor of the compulsory treatment are supported by empirical evidences. “Despite the objections there has been no definite evidence that compulsory treatment results in a worse outcome for anorexia nervosa. Thus far, support for this view has been only anecdotal.” (Griffiths and Russell, 131) In a reflective exploration of the controversial question concerning compulsory and coercion treatments, it becomes lucid that treating the disorder with compulsory and coercion treatments will diminish the possibility of the victim to fall into the same disorder again. This is a major argument put forward by the proponents compulsory and coercion treatments of anorexia nervosa. It is essential to realize that “such treatment reduces hospital recidivism, improves medication compliance and permits better use of community resources.” (McIvor, 369) Therefore, it is obvious that compulsory and coercion treatments help reduce the possibility of the victim to fall into the same disorder again. The strong cause of the proponents of compulsory and coercion treatments in anorexia nervosa is served also by the fact that forced treatments are not a matter of breaking the law and the parents or partners of victims are in favor of the treatments. It must be realized that there is no breaking of law involved when a patient is forced to undergo treatment as it can be life saving in the short term. It is a case of strong paternalism where the clinician is entitled to intervene independently of the patient’s wishes for the protection of his/her own wellbeing. “Parent’s families and partners are usually in favour both in theory and practice… It is not ethically acceptable to let a young person with a short history of severe anorexia die or be at significant risk of dying if we can prevent this.” (Freeman, 2) Another main argument made in favor of enforced treatment of anorexia nervosa has been that the victim of anorexia nervosa should not be left to die if he or she can be treated. It is fundamental to comprehend that the anorectic patient is conditioned to experience starvation and he or she can exercise starvation as more satisfying than eating. “Early vigorous nutritional rehabilitation should proceed to full weight restoration despite the patient’s reluctance. In practice, however, treatment refusal may result in delayed or incomplete treatment and the anorectic process may become irreversible.” (Griffiths and Russell, 128) In conclusion, a reflective exploration of the importance of compulsory and coercion treatments of anorexia nervosa confirms that the arguments made in favor of enforced treatment are so convincing and legitimate that its usefulness cannot be questioned. It is an empirically proven fact that patients with anorexia nervosa need to be treated in order to prevent their death. There is a general agreement among the scholars that an action must be taken in order to treat it as soon as possible, if an eating disorder like anorexia nervosa can be treated. In short, compulsory and coercion treatments are necessary in order to stabilize the mental disorder of a victim of anorexia nervosa, save their lives, and treat the disorder in such way that there is no possibility that the victim will suffer from this eating disorder again. Works Cited Dresser R. “Feeding the hungry artists: Legal issues in treating anorexia nervosa.” Wis L Rev. 1984. P 297–374. Freeman, Chris. "Ethical Considerations in Compulsory Treatments of Eating Disorders." Eating Disorder Network. 2010. P 1-5. Griffiths, Rosalyn and Janice Russell. “Compulsory treatment of anorexia nervosa patients.” Treating eating disorders: Ethical, legal and personal issues. Vandereycken W, Beumont PJ. (Ed.) London: The Athlone Press. 1998. P 128. McIvor, Ronan. “Care and compulsion in community psychiatric treatment.” Psychiatric Bulletin. Vol. 25. 2001. P 369-370. Palmer, RL. Anorexia Nervosa. London: Penguin. 1980. Rathner, G. “A plea against compulsory treatment of anorexia nervosa.” Treating eating disorders: Ethical, legal and personal issues. Vandereycken W, Beumont PJ. (Ed.) London: The Athlone Press. 1998. P 179–215. Tan, Jacinta O.A. et al. “Attitudes of patients with anorexia nervosa to compulsory treatment and coercion.” International Journal of Law and Psychiatry. Vol. 33. Iss. 1. 2010. P 13-19. Tan, Jacinta O. A. et al. “Competence to make treatment decisions in anorexia nervosa: thinking processes and values.” Philos Psychiatr Psychol. 2006. Vol. 13. Iss. 4. P 267–282. Touyz, Stephen W and Terry Carney. “Compulsory (Involuntary) and Coercion Treatment for Anorexia Nervosa.” The Treatment of Eating Disorders: A Clinical Handbook. Carlos M. Grilo, James E. Mitchell. (Ed). Guilford Press. 2009. P 212. Watson, T., et al. “Involuntary Treatment of Eating Disorders.” American Journal of Psychiatry. Vol. 157. 2000. P 1806-1810. Yager, J. “The Management of Patients with Intractable Eating Disorders.” Eating Disorders and Obesity: A Comprehensive Handbook. New York: Guiliford Press. 1995. P 376. Read More