Human Rights and Human Experience in Eating Disorders

Over the last quarter century, hospital admissions for eating disorders such as anorexia nervosa have continued to rise. During that same period, the law pertaining to food-refusal has generated new challenges. New legal principles have come to prominence in the ongoing effort to introduce robust human rights protections in care settings. And we are seeing a subtle but important shift in the legal framework within which cases of persistent food-refusal are adjudicated. An earlier legal approach could focus narrowly on questions of whether, for example, anorexia nervosa is a mental disorder, whether a particular person living with anorexia presents a “danger to self or others,” and whether involuntary hospital treatment is effective. By contrast, the emerging legal approach explicitly requires attention to the decision-making processes at work in food-refusal, and to the “beliefs and values” that inform a person’s “will and preferences” – both as regards food and as regards treatment. The old questions were hard. The new questions are harder, and they call for new forms of investigation into the phenomenology and psycho-social dynamics of food-refusal.