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1984 Wis. L. Rev. 297 (1984)
Feeding the Hunger Artists: Legal Issues in Treating Anorexia Nervosa

handle is hein.journals/wlr1984 and id is 317 raw text is: ARTICLE AND COMMENTARY ON ANOREXIA NERVOSA FEEDING THE HUNGER ARTISTS:* LEGAL ISSUES IN TREATING ANOREXIA NERVOSA REBECCA DRESSER** Sufferers of anorexia nervosa typically starve themselves while refusing therapeutic intervention. In this Article, Professor Rebecca Dresser critically evaluates the traditional legal standards and procedures for compelling treatment, in light of the present state of medical understanding of anorexia nervosa. The cultural and psychological features of this condition, as well as the potential harmful consequences of unwanted treatment, lead Professor Dresser to endorse restrictive interpretations of the civil commitment and legal incompetency standards authorizing imposed treatment of anorexic patients. She advocates legal rules that give certain anorexic adults the right to refuse even lifesaving treatment and anorexic minors greater authority to consent to or refuse treatment. Legal standards that narrowly limit involuntary treatment, Dresser contends, will encourage more careful examination of the sociocultural context of anorexia while furthering both long term therapeutic goals and respect for the autonomy of the anorexic patient. Anorexia nervosa is an eating disorder that has reached epi- demic proportions.I For some individuals, an episode of anorexia is mild and transitory, merely a phase of their adolescent develop- ment.2 Others, however, will die from the condition. Reports in the professional literature cite death rates of up to 19%;3 the true death rate could be even higher because the death of an anorexic may be attributed to another cause, such as cardiac arrest or suicide.4 * Kafka wrote four stories under the heading, A Hunger Artist. F. KAFKA, WEDDING PREPARATIONS IN THE COUNTRY AND OTHER STORIES 156-90 (Penguin Modern Classics ed. 1978). One such story, entitled The Fasting Showman, is an eerie account of one individual's self-starvation. Id. at 165-74. ** Assistant Professor, Center for Ethics, Medicine and Public Issues, Baylor College of Medicine. J.D., Harvard Law School. Much of the research for this article was conducted while the author was a Bigelow Teaching Fellow at the University of Chicago Law School. 1. A. H. CRISP, ANOREXIA NERVOSA: LET ME BE 21-22 (1980). 2. P. DALLY & J. GOMEZ, OBESITY AND ANOREXIA NERVOSA: A QUESTION OF SHAPE 82 (1980). 3. See Swift, The Long-Term Outcome of Early Onset Anorexia Nervosa, 21 J. AM. ACAD. CHILD PSYCHIATRY 38, 41 (1982) (reviews studies showing mortality rates of 0-18%); Hsu, Outcome of Anorexia Nervosa: A Review of the* Literature, 37 ARCH. GEN. PSYCHIATRY 1041, 1042 (1980) (reviews studies showing mortality rate of 0-19%). 4. See A. H. CRISP, supra note 1, at 31.

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