Legal and Ethical Issues
· In giving the treatment, the doctor should focus on the individual, his/her rights, feelings, thoughts and concerns regarding treatment, with due consideration given to the family and also to the social and cultural environment that the patient come from.
· In a nursing framework, mechanisms should be established to foster ethical practice care, reflective practice, examination of critical incidents and clinical supervision.
· Hospital staff may be instructed not to be moralistic or judgmental.
· Many patients get back to their routine and loose weight again after receiving treatment due to the bad attitude showed by the staff.
· Intervention procedures in the treatment such as forced feeding might disrupt the relationship between doctor and patient. Patient might hinder obtaining medical help even for minor ailments and injuries.
Consent:
· Implementation of any legislation which allows treatments against a person wishes remain an issue of continued debate.
· Under common law, a doctor may only administer treatment when a patient gives consent, otherwise they may commit trespass(a person’s rights to his or her body have been infringed by the direct interference, whether intentional or negligent, of another, in the absence of lawful justification), assault or battery(any intentional touching of a person without lawful justification or without their consent).
· All adults are assumed to have legal capacity unless there is evidence to the contrary.
· If the anorexic is not mentally competent, due to the effects of starvation, then the doctor can give treatments to him/her. If the patient had been well, he/she would not have objected to such a procedure.
· There are cases where food refusal does continue after compulsory admission and then artificial feeding usually by nasogastric tube may be deemed necessary as a last resort.
· For the minor(below 18 years old), consent for treatment can be given by the person who holds parental responsibility. If this consent is still not forthcoming, the court will intervene.
Confidentiality:
· The doctor should apply the rule of confidentiality when dealing with patient illness.
· It can be breached if the patient or others are at significant risk and where informing a family member or carer is likely to reduce the risk.
Issues that might be faced by doctors:
· Difficult to develop a cooperative approach because many patients who come to the doctor are not ready to change their behavior yet. They may be forced to see the doctor by their families. Also, it would be as a disadvantage for the doctor if he/she does not have any kind of relationship with the sufferer. It would be easier if the doctor already know the patients and have treated them before.
· Doctors could be in the situation where they have to decide what the best action is if the patient refuses to receive the treatments. They want to help the patient but at the same time they have to abide the law and ethics in medical profession.
References:
a. Anorexia Nervosa and Bulimia: How to help, written by Marilyn Duker and Roger Slade, 2003.
c. http://books.google.com.my/books?id=Lg8zSwM9UIQC&pg=PA138&lpg=PA138&dq=ethical+issues+in+anorexia+nervosa&source=bl&ots=j-jELsoE4-&sig=Y2tKn48xmPPCz4edSeguB23zBMo&hl=en&ei=ppdmSrOuBpj_kAXE8aj5Ag&sa=X&oi=book_result&ct=result&resnum=7
d. http://www.nice.org.uk/nicemedia/pdf/cg009publicinfoenglish.pdf
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