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Reflections

Justice still anorexic?

5/9/2020

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Force feeding not in anorexia patient's best interests - UK Human Rights Blog, (Northamptonshire Healthcare NHS Foundation Trust v AB [2020] EWCOP 40)

Force feeding not in anorexia patient's best interests - UK Human Rights...Patient suffering from extreme eating disorder found not to have capacity, but further gastro-nasal feeding was ...
One commentator on the Human Rights Blog  argues the case  had been about whether the patient had the mental capacity to decide against force-feeding..With respect, this kind of reducing matters to fine legal points in my eyes means removing substance and context from the case. Formally they may have been right. But what is Justice for if not decide real-life cases:The Trust would not have argued that the patient did not have capacity if it was not for the fact they, the Doctors, thought they knew what was best for the patient (in her best interest). It would be interesting to see whether the Judge did consider that these were Doctors who had been unable to treat  the patient with any success for years, and if so in what light:. Commonly, under prevalent psychiatric concepts the patient is seen as the problem and as resisting therapy. Increasingly, and rightly in my view, survivors of such treatment who found other means to get better, argue that instead of asking 'what's wrong with you' - the  question 'what happened to you' should be asked. In-depth psycho-social and cultural investigation would at least have the chance to enable the patient to see her stuckness as socially constructed.
While the Judgment may be preferred over the alternative in this case (which would have been to allow force-feeding) it seems to me, ultimately, the Judge may still have failed to address the causes and the context: The Trust, the doctors, in this case seem already far removed from thinking about the patient's best interest. Justice, perhaps with the help of expert witnesses, looking deeply at the reality of either application in this case might have contributed to reversing that, might have applied human wisdom:
The Doctors would not need to be force-fed, only encouraged to seek treatment  options the patient could agree on. Since it can be assumed that they have the capacity to do so, it seems to be negligent not to do so. I do not know what if any psycho-social interventions were tried in the case at hand. However, I deduct from the fact that the Doctors (and the Trust) arrived the view they did (about force-feeding being in the patient's best interest) and also from my own experience working with Psychiatrists and other medically oriented mental health professionals: Where the investigation how to help a human in their care does not cast a wide net reaching all their life circumstances and human reasons for those, the ethical roots of  do not reach deep enough to be nourished by the desire to truly support a valued independent life and vice versa. 
I have met one exception - a young female Doctor who maintained a deeply human approach even while the system in which she worked did not give her any tools to apply it. She, of course, too ended up feeding a system that worked against her. deepest intentions.

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    Author:

    Barbara Schaefer, Social Care expert, Action Methods/Drama Practitioner,Contemporary Theologian - attempting a deep look at issues of social justice:

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