Tag Archive | Independent

Anorexia and Autonomy (part 2)

In researching to write my previous post on this topic, for all my reading around on science journals and NHS factsheets, I missed the most important article I’ve read on the topic yet. Ilona Burton’s honest, elegant and profoundly thought-provoking account of her own experiences in the Independent, “force-feeding: there was a time when I would rather die than eat the food in front of me” is much more worthy of a read than the cumulative scholarly articles I came across.

My previous hang-up was over whether we can truly, fairly say that the woman in the current case can be deemed to be incapacitated by some combination of her physical and mental condition to the extent that she lacks legal autonomy. I say this tentatively as I’d hate to put words in her mouth, but Burton seems more concerned with a different question, one which I hadn’t fully considered;

Since 1997, doctors have had the power to force-feed anorexic people in order to prevent them starving themselves to death. It’s a desperate situation, but when a person is so entrenched in an illness that constantly tells you that food (and sometimes drink) is the enemy, you become paralysed with fear and will do anything, no matter how out of character, to avoid it. Many of the nursing staff I have spoken to about this have told me that they have struggled more when trying to restrain a frail, skeletal anorexic person than a fully grown burly male.

The argument for force-feeding is that the person in that position is not capable of making that decision for themselves, and so (lawfully) it is in their best interests. I would worry how many more deaths we would have from anorexia if it was not allowed.

But should ‘E’ be forced to continue a life (if you can call it that) that she no longer wants to live?

The question it comes down to really is over whether treatment is futile when a person is so far down that line of self-destruction.

I still haven’t properly considered the possibility of futility of treatment because I have no ability or qualification to do so, but it adds an extra dimension of confusion to an already baffling case. The available academic work I’ve come across, some of which is cited in my previous post, seems to suggest that they think there is always hope, but I was certainly struck by the extremity of this case relative to the ones they were often commenting on.

Moving on, Burton says;

I have never been as ill for as long as ‘E’, and even if I had, I would have no place to say whether this decision is right or wrong – nor do any of us.

and I think, in agreement, that’s where I’ll leave off commenting on the issue. I have never had to face anything like the struggles that ‘E’ has. I have no answers. What reflecting on this has left me with, however, is an increased sense of my gratitude for being fortunate enough to not have to face a daily trial like that. With thought to ‘E’, I’d readily echo Burton’s conclusion;

My fingers are crossed.

Nobody becomes Prime Minister “by default”

Matthew Norman today vocalises the dirty dreams of the average Labour supporter – “Has the moment come seriously to consider the prospect that Ed Miliband will be our next Prime Minister?”
His justification is really interesting. Forget all the media wisdom of the last couple of years, founded on the idea that Cameron’s slick PR machine can steamroller anything the ostensibly febrile Miliband offers, and instead consider –

Could he become Prime Minister by default, much like the incumbent, simply by being slightly less off-putting a presence than his rival? Might his optimal strategy be to accept his own presentational difficulties and the fearsome lack of interest in national politics by keeping his trap shut, and leaving the Government to continue its super slo-mo implosion?
The sequence of blunders over which the PM has latterly presided – most arising from the Budget, but with the cobblers about electronic surveillance lending the incompetence impressive range – has been startling, and the speed of his U-turns dizzying. Even when a policy is broadly popular and correct – what gives anyone the right to spend their taxes as they choose? – he is so scrambled by the cumulative post-Budget contempt that he pirouettes in a flash.
The football chant that perhaps captures the nascent public feeling is the one reserved for the manager of a relegation-threatened side after a particularly obtuse substitution: you don’t know what you’re doing.

David Cameron in disguise, according to Matthew Norman

I’m strongly minded to reject this. Firstly, it underestimates the extent to which the Tories are still comfortably in control. Occasional poll victories mean very little. As Norman reminds us,

Michael Foot and Neil Kinnock consistently had larger leads over Mrs Thatcher, and were routed.

The reality is that the Tories are still well in control of the popular discourse on the big stories, which might have slipped down now but will resurface around election time – deficit reduction as an overall strategy being the key one, along with its corollary: reducing the public sector. The message that these things are not necessary remains the preserve of the grassroots left-wing. If Labour attempt to coast into the next election without taming that lion, they will spend another term in opposition – of that, I am certain.
Moving on, the second objection I hold is that I think this underestimates the capacity Labour have to be credible, proactive contenders rather than just hiding and waiting. There is a huge bulk of untapped public opinion against the current direction of economic policy, supported by a message found everywhere in the media, from the blogs of the Guardian to the lyrics of rapper Plan B, “we don’t really like all this talk of austerity and pain, and we’d like an alternative.” Labour can offer that alternative in a sensible, widely acceptable way, provided they’re ready to fight back when the right turn on them with angry accusations about the (mythical – see what will hopefully be tomorrow’s update!) profligacy of New Labour.

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