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Anticipatory obedience

Published online by Cambridge University Press:  02 January 2018

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Abstract

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Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Copyright © Royal College of Psychiatrists, 2011

I fully agree with Dr Hakeem. Reference Hakeem1 There seems to be a wrong perception among nursing staff as well as occasionally medical staff that a patient’s choice to overeat is a human right. The opposite is the case. There is no ‘human right’ to eat as much as one wants to. Article 3 of the Human Rights Act 1998 forbids degrading and humiliating treatment (as part of the right to be free of torture), but this relates to seriously degrading practices. It does not at all mean that we need to allow any choices a patient wants to make. It does even allow a degree of institutionalisation as long as it is not deliberately degrading. If it did not, hospitals would not be able to function properly, as certain routines have to be maintained to allow the running of a hospital. Giving unnecessarily large amounts of food to patients could even be seen as a neglect of our duty of care, especially if the patient lacks capacity. If I was diagnosed with schizophrenia and started on clozapine under Section 3 (of the Mental Health Act), I would hope that the people treating me would have enough sense to stop me from eating three times as much as necessary, even if I did ask for it. So, rather than being defensive in anticipatory obedience and the wrong understanding of human rights legislation, we should use our common sense and duty of care, and prevent patients from doing serious harm to themselves by overeating while they are in our care.

References

1 Hakeem, A. No physical health, only mental health. Psychiatrist 2010; 35: 156–7.Google Scholar
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