[Update: I originally referred to a hypothetical anorexic throughout this post with the pronoun ‘she’. This reflected that my initial post was sparked by a new legal ruling which did, indeed, involve an anorexic woman. But a friend has pointed out that by now it appears I am assuming anorexics are necessarily female, which is both false and thereby unhelpful. Neutral pronouns are now in place].
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. In talking with a friend over the years about her eating disorder, I’ve come to think that such rationalism is just not the case. Severe malnutrition affects decision-making as much as the skewed self-image that drives the behavior in the first place. Add the fact that the person may not have eaten in so long that doing so leads to severe nausea, creating a further aversion to eating, plus years of severe depression and hopelessness that can ultimately manifest as a death wish, and you’ve got an out-of-control situation that requires serious intervention.
This is the same objection I considered yesterday: namely, that anorexia precludes autonomy by fostering irrationality, so force-feeding is fine. I started by wanting to know more about this invocation of “rationality”, but by the time it came to the comments thread I took up John Magruder’s suggestion that anorexics are irrational because they hold false beliefs about the effects of food, and my main concern was to doubt that, despite appearances, this type of irrationality can justify coercion.
Let me try to explain my reluctance on this issue, one final time.
Consider Jehovah’s Witnesses. Infamously, they oppose blood transfusions on the grounds that an individual’s blood is sacred and therefore sharing it is wrong. Now, they would no doubt claim that the truth of this principle depends upon the will of God, and we have no way of knowing whether it’s accurate. But for the sake of my point, this is irrelevant. It doesn’t matter that we cannot prove what we suspect: that, to put it mildly, their view is misguided. All we need to note is that even if we were sure that their view was nuts – even if we could somehow prove it – would we wish to care for them by compelling them to take blood donations accordingly? No. But why not? After all, those arguing for force-feeding anorexics were doing so by noting that they are irrational because they hold false beliefs; ex hypothesi, just like the Jehovah’s Witnesses.
Or maybe something less contentious will suffice. 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.