It wasn't a book; it was a paper, just to be clear.
What we were arguing for is that patients with eating disorders are like other mental health patients, and sometimes, because of the illness, they're not capable of consenting to treatment, particularly when they're really young. In the case of voluntarily allowing a 12-year-old to refuse treatment, we have to really...[Technical Difficulty—Editor]...whether she really understands the ramifications of what she's doing.
The feminist perspective was to talk not just about this idea of informed consent and having the freedom to make decisions, but it was also about responsibility and what families owed each other in terms of taking care of each other. Most people live in families and make their decisions independent of their family.
Sometimes people refuse treatment because they can't afford child care. I have seen someone delay their treatment for an eating disorder because they didn't have enough child care over the Christmas holidays. They couldn't do the treatment because they had to be home for their children.
This paper was arguing not necessarily that treatment should always be forced, but that people live in families, and it's about doing no harm and making sure that families can keep their family members safe.
As with other mental health disorders, when they are no longer able to make rational decisions for themselves, we have to step in the same way we do for other disorders. It was done as a direct response to not stepping in when it was clear that people were so starved they were not thinking clearly and had at previous times chosen therapy or would have likely chosen treatment had they had all their capacities intact.
We should not allow those people to make decisions that end their life. We don't do that in schizophrenia. We don't do that in depression. We should not do that in eating disorders. I have colleagues who can't step in because there's nowhere to treat patients. There is no one that will take them into a locked unit. They don't have the same rights.
I would argue that I don't think 10-year-olds or 12-year-olds have the capacity to decide to die from an eating disorder. I take those things very seriously.