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Presuming incapacity in anorexia nervosa is indefensible: A reply to Ip.

Authors
  • Miller Tate, Alex James1
  • 1 Centre of Medical Law & Ethics, Department of Philosophy, King's College London, London, United Kingdom of Great Britain and Northern Ireland. , (United Kingdom)
Type
Published Article
Journal
Bioethics
Publication Date
Jul 01, 2021
Volume
35
Issue
6
Pages
596–601
Identifiers
DOI: 10.1111/bioe.12879
PMID: 33890689
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Eric C. Ip has recently argued that seriously anorexic service users ought to be assumed to be legally incapacitous to refuse life-saving artificial nutrition unless they can demonstrate otherwise, reversing the ordinary legal presumption in place to protect patients' liberty and values. In this response, I argue against this proposal on two grounds. Firstly, the proposal is wrongfully discriminatory; it would expose service users to serious harm, and wrong them in numerous ways, on the basis of their diagnosis alone, without significantly benefitting them in any way relative to the status quo. Secondly, he is unable to show that a large majority of such service users actually are incapacitous to refuse life-saving artificial nutrition. This means that his proposal would likely involve declaring a large number of actually capacitous patients to be incapacitous, without even the requirement of a formal assessment, and burdening them with the responsibility of proving their clinical team wrong if they wish to avoid deprivation of liberty and/or compelled treatment. Given this, his proposal is indefensible. © 2021 John Wiley & Sons Ltd.

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