Sally, a 22 year-old woman has been suffering from anorexia nervosa for six years. The recent weeks have seen her condition worsen to the extent that the Medical Officer has resulted to prescribing her artificial nutrition, PEG feeds, administration. Sally has however refused the artificial feeding, let alone the insertion of the PEG tube. Essentially, Sally is just an exemplar of the numerous cases that nurses’ encounter when patients refuse treatments that could save their lives. Hendrick (2000) indicates that in such cases, nurses, with patients’ best interest at heart question the possibility of employing coercion or other means to make the patient undergo the treatment. Veitch (2007) warns nurses or any medical practitioner on making patients comply with treatment citing that in healthcare, best ...view middle of the document...
However, the complexity, in reference to the limited nature of the law and respect for autonomy as an ethical principle coupled with the characteristic of anorexia nervosa, as a psychological disorder that makes a patient incompetent to make medical decisions reveal that against all odds, Sally has no legal right to refuse her treatment.
One of the contributing factors to developing anorexia is an individual’s need to control his or her
environment. In my opinion, force feeding a patient who suffers from this serious disorder, would
be unethical as well as a violation of the patient’s constitutional rights. The libertarian philosophy
of freedom is based on the premise that self-ownership is a basic right and that initiating violence
against others is a fundamental wrong. What is self-ownership if not the right to choose what, or
how much, to ingest? What is initiating violence against another if not forcibly incarcerating Sally
for ingesting too much or too little of a particular substance?
When Sally says “no” to recommended medical technology and treatment, she brings into
struggle a confusing array of rights, emotion and obligations. For the patient it is about self-
determination and their ability to participate in their own care. The family is often torn between
respect for the patient’s right to self-determination or religious ideology and of course the natural
desire for their loved one to survive, while the state claims an interest in the value of life and a
duty to protect the interest of dependents. Herbert and Weingarten indicate “the standard
approach to such dilemmas usually refers to the principles of ethical analysis: patient autonomy
(following a competent patient’s wishes), medical beneficence (helping the patient) and justice