Imagine starving yourself for so long that your brain is telling you how normal it is, that everyone does it. That you refuse to eat because you want to be skinny yet your brain is playing tricks on you, telling you that you are fat and showing you distorted images of yourself to keep you from eating. It is at this point on an anorexic patients journey that the procedure known as ‘force-feeding’ sometimes occurs. This is a highly controversial medical intervention: medical experts claim it is essential to save a human life, but some patients say it is a breach of their human rights. Roughly one in every hundred women aged between ten and twenty stop to eat and begin to starve themselves to the verge of death, bringing the issue of force feeding further under the spotlight.

Most people suffering from anorexia cannot form an independent and rational judgement regarding the consequences. Last month a judge from New Jersey granted guardianship to the parents of a young wonan suffering with the eating disorder arguing that their daughter is incapable of making independent medical decisions. This makes it easier for the parents to be in control of treatment decisions for the young woman, which does include the option of force feeding. Force feeding can save the lives of individuals who are suffering severely with anorexia. It is a legal procedure and the treatment is provided under the mental health legislation. A study carried out by eating disorder hope in 2015 has shown that the brain of a sufferer of the eating disorder anorexia works differently compared with how a healthy brain should work. Schlesinger, a mother whose daughter died of anorexia gives us an insight into how her daughter’s brain worked: “They don’t see themselves as what they really look like, when a person with anorexia who is emaciated looks in the mirror, they see fat, they get anxious, and it’s very real for them”, she said. Malnutrition accompanies eating disorders, and it has been proven that it shrinks the brain and affects the cognitive function, which then interferes with the persons ability to acknowledge the necessity of treatment.

However, on the other hand, force – feeding may only be successful for a short period – of time or may not be successful at all in some cases which is then a waste of time and has put the individual through a traumatic experience for no reason at all. A leading judge who sits in the court of protection has said that a medical student who suffers very severely from anorexia nervosa and is at a life threatening weight, should be force fed against her wishes by doctors. But a member of the British Medical Associations Ethics Committee says, “ The implications of force-feeding are really significant because she would need restraining or sedation and the treatment would last a year…. it might not succeed and itself is life threatening. To impose that on a patient who might be competent in refusing treatment is a major step”. These words show clearly that force – feeding is not a decision to take lightly.

Saving the lives of individuals who suffer from anorexia nervosa is more important than their dignity. There are so many other medical procedures used regularly that could be deemed ‘undignified’; for example stomas, chemotherapy etc. These procedures are considered to compromise patients’ dignity because they have possible side effects such as baldness, yet they save lives everyday just like force – feeding. Everyone’s life has a purpose, their story is important, their dreams count, their voice matters, they were born to make an impact. Imagine if that was your daughter, son, brother, sister, mum, dad, auntie, uncle starving themselves to death, that the only way to save their life was to force – feed them. Imagine you had the option between saving their dignity or their life. Without thinking about it, you would choose to save their life rather than choose their dignity because you would not want to see your loved one dead. Schlesinger tells us what she thinks: “You have to do everything and anything to try to save your child, even if it means getting a conservatorship to make sure that they get the proper treatment”. Her passion highlights that force – feeding should not be dismissed as an option.

But then again, many people claim that force – feeding is an unethical procedure. Doctors and Judges walk a fine ethical line when deciding if people with eating disorders should be treated against their own wishes. If you decline life saving treatment for cancer, that is your right to do so. If you have a substance abuse disorder or you are an alcoholic, nobody will force you to go to rehab unless you have been caught breaking the law. So what does it take for an individual to be forced to go through medical treatment against their own wishes and beliefs. There will have to be an expectation that the treatment has a good chance of success; ineffective care given against the wishes of a patient suffering with anorexia cannot be justified ethically.

Yet such treatment may be the only way forward to address the psychological problem. Some psychotherapists insist that there is a necessity for immediate weight gain in order to help a patient who is suffering with anorexia nervosa to open up and be able to be eligible for talking therapy. Some of the patients who were very severely underweight and at a critical stage were then force fed by a doctor. Many of these patients, even the ones who viewed force feeding as an ordeal, ended up being very thankful and acknowledged this as the first step of their recovery. This is what one of the anorexic patients who were force – fed has said about her battle: “Now looking back, I simply couldn’t see the wood for the trees, for I didn’t then want a life. However, now three years further on, I can see tube feeding is the last resort with the person’s best interests. Without the help of the tube I know I wouldn’t be here now”. This suggests that force – feeding is in the long term interests of the patient, even though they may not appreciate this at the time.

Conversely it has also been said that force feeding could lead to other severe mental health issues such as depression and anxiety due to the trauma from force feeding. However this could lead to the individuals having to go through more medical treatment such as counselling, drugs and therapy which then prolongs the trauma. “The National Institute of Mental Health estimates that up to 75 percent of those with an eating disorder also suffer from depression or anxiety.” This shows that force – feeding has a very high chance of leading to other mental health disorders. So is it really worth force – feeding to stop one mental health disorder, to start another?

In conclusion I neither agree or disagree as there has been valid points made for both sides of the argument. Some individuals who suffer with anorexia can’t make rational and independent decisions themselves as malnutrition and anorexia have been shown to shrink the brain, It could be the only way forward to help treat anorexia physically and mentally because eating food becomes a true fear to individuals it’s like a fear of spiders or flying no matter how many graphs and statistics that show flying is safer than driving, that fear will still be there. But on the other hand it may lead to more mental health problems like depression and anxiety which then leads to the patients having to go through more medical treatment like therapy and counselling. So what will it be life or death?