A recent court ruling has sparked controversy over the treatment of women with anorexia and diabetes who refuse medical care. The ruling states that these women can be detained and force-fed through tubes, raising ethical concerns and questions about bodily autonomy. In this article, we explore the implications of this ruling and the challenges it poses for those with dual diagnoses of anorexia and diabetes, as well as the broader debate surrounding medical intervention and human rights.
The High Court has granted orders to the Health Service Executive (HSE) to detain and tube-feed a young woman with anorexia nervosa and diabetes who lacked the mental capacity to understand the danger posed to her life by her illness. High Court president Mr Justice David Barniville ruled in favour of the HSE after a treating psychiatrist testified about the woman’s refusal to accept her doctors’ advice regarding the risk involved with self-treating her diabetes while not eating properly.
The woman was suffering from anorexia and type-1 diabetes and was admitted to hospital in September, where she remained until February before receiving treatment on an outpatient basis. However, she was recently readmitted due to concerns over her weight loss and insulin intake. As she needs intravenous dextrose, she is currently in a general medical ward, where she will have to stay for several weeks until her condition is stable.
The woman’s psychiatrist evaluated her mental capacity and found that she was in a state of hopelessness and did not believe that her situation warranted treatment. However, the endocrinologist managing her diabetes shared the psychiatrist’s concerns.
As the lack of mental capacity was partly due to her anorexia and partly due to her low food intake and weight loss, the judge ruled that there was a high risk of her brain being affected, leading to a fatal outcome. Therefore, a nutritional regime was necessary, and if required, nasogastric tube feeding should be initiated. The judge also said that the woman would require 24-hour nursing care, which should be minimal and may require restraint.
The judge appointed a solicitor as a court-appointed guardian, and the case is set to come back in April. In his ruling, the judge was convinced that the orders were necessary and appropriate for the woman’s best interests and to save her life. The woman, who declined to participate in the court hearing, will spend at least three weeks in a medical ward before being moved to a psychiatric ward.
In conclusion, the recent court ruling regarding the detention and tube-feeding of women with both anorexia and diabetes has sparked controversy and debate. While some argue that it violates personal autonomy and individual rights, others see it as a necessary measure to save lives. It is important to recognize that eating disorders and diabetes are serious medical conditions that require comprehensive and compassionate treatment. As a society, we must continue to explore ways to support and empower those struggling with these challenges, while also ensuring their safety and well-being. Ultimately, the decision to detain and tube-feed someone should not be taken lightly, but rather as a last resort when all other options have been exhausted.
