There was news of the recent death of a Dutch teenager. Early reports that she had been euthanized were incorrect, although she had sought a medically assisted death because she had been intractably miserable with PTSD, depression, and anorexia as a consequence of sexual assault. Her request was denied, so she instead chose to stop eating and drinking, which (if current reports are accurate) is what ultimately resulted in her death.
In the US, we can institutionalize someone, at least for a brief period, if there’s evidence that they are a danger to themselves. Does the law also permit us to force them to accept nutrition and hydration, against their wishes?
Don’t know about the rules in the US, but in most countries you can only be involuntarily detained under the mental health legislation if you are or may be mentally ill. Wishing to die is not, in itself, a mental illness, and neither is refusal of food. There would have to be some further facts to justify involuntary detention, never mind force-feeding.
In general a mentally competent adult can refuse to eat or drink, and attempts to force them physically do to so would be assaults. Back in the day, the British government did force-feed Suffragist hunger-strikers in prison, justifying what would otherwise be a criminal assault by reference to the right of the prison governor to discipline prisoners physically, but that would not be done today.
The thing is, though, refuse food for long enough and you will eventually become comatose. At that stage medical decision-making is likely to pass to next of kin and, if they are not supportive of your wish to die, they may authorise tube-feeding and artificial hydration.
Of course, in time you will then recover from your coma and can then refuse food again until you once more become comatose. Rinse and repeat. Treating your body like this is not good for you and you will eventually die of infection or heart failure, but it may take a while. You may be able to short-circuit it, if the laws of the jurisdiction provide for this, by appointing an attorney/representative who is sympathetic to your wish to die to take medical decisions on your behalf, in place of your next-of-kin.
The *Suffragists *led by Dame Millicent Garrett Fawcett were the ‘peaceful protest’ wing of the women’s suffrage movement. It was the Women’s Social and Political Union (WSPU) aka The *Suffragettes * controlled by the three Pankhursts, who resorted to violent protest and suffered horribly as a result.
It is generally accepted these days, that the Pankhurst Campaign did more harm than good for the cause. While Pankhurst may be the better known, it is Fawcett that had a statue recently unveiled in Parliament square.
Either way, it was public protest about the force-feeding of protesters that bought about the law that now prevents it.
If a court grants guardianship to someone else, it can happen, at least in an institutional setting, but it isn’t always clear.
As with most things, it’s complicated. The cite above mentions that patients with severe anorexia often present differently from people with other, life-threatening disorders, and come across to judges as more rational and believable.
According to the article I linked to, the Dutch teenager was suffering from anorexia, depression and PTSD, all three being regarded as forms of mental illness. Is it correct to say then that if she had been in the US, she would not have been permitted to starve herself to death?
FWIW, we board people on mental health holds in my ER, sometimes for days, waiting for placement or transport to a mental health facility. We offer nutrition routinely, but I’ve never heard forcing it even discussed.
In the US penal system, convicted felons are wards of the state. So the state will step in to prevent significant self harm. Court orders for feeding tubes are not uncommon when the patient has fasted himself into a critically state.
Were the patient neglecting nutrition due to underlying malignant disease, they’d not intervene. But when done in the context of “I will kill myself if you don’t let me go”, the state doesn’t allow it to occur.
A friend of my wife decided she was through suffering and, with the knowledge and agreement of her husband, stopped eating and drinking and died within a week or so. But she was quite ill and her husband accepted it. This happened in Nova Scotia.
It’s not unheard of for dying people to stop eating and drinking even without intent to seek death. The last couple weeks of my mother’s life she had stopped eating and eventually drinking simply because everything was shutting down and she was often unconscious.
Which is different than a fast starting from decent physical health with the intent to end in death, but the end result is much the same.
I wonder what would happen with a contempt of court case. Joe Reporter refuses to reveal his source, the judge says he must and jails him for contempt (not a felony) until he complies. Joe Reporter refuses to eat while locked up. What would happen next?