Opposing Principles?

A 27-year-old woman who has struggled with anorexia nervosa since she was 11 years old is extremely intelligent, and having gained a first-class degree in history at Oxford University, she is now halfway through her PhD. It is at times when her life is most stressful that she struggles with her anorexia. The first time she was admitted to hospital was when she was 13. She was being badly bullied at school and had stopped eating in order to become thin to prevent being teased about being overweight. Being able to lose so much weight gave her the sense that she had some control over at least one aspect of her life. She has spent the past 14 years in and out of hospital. On two occasions she had to be admitted to intensive care as she had lost consciousness.

Although you want to feed her by nasogastric tube to prevent her needing a third admission to intensive care, she adamantly refuses to have this. She tells you that she does not want to die, but neither does she want to be force fed.

• Should this patient should be force fed?
• Why? Why not?
• What evidence (legal/ethical) can support your decision?

Apply Theory (Specific Professional Healthcare Competencies + Clinical Medical Ethical Principles) to Practice in order to provide Optimal Patient-Centered Care (OPCC)

Clinical Ethics and Law, Second edition. Carolyn Johnston, Penelope Bradbury, Series editor: Janice Ryme