Perhaps in the past paternalistic medical era, physicians thought of themselves as the “parent” of the patient who would rush in and pull their patient out of harms way. These days, we teach our medical students that physicians are moral equals of their patients and that each individual in the relationship has something to contribute. Physicians are there to examine, evaluate and educate the patient but a patient who has the capacity for medical decision-making is the one, after being informed, to set their own course. As physicians we may disagree with the patient’s decision and we may decide not to participate but the final decisions are up to the patient. ..Maurice.

the point above, that “threats, coercion and punishments have no place in the treatment of eating disorders” illustrate that quite nicely.

the term “compliance” illustrates it nicely, too – it’s not a term that would be used among equal partners.

how, then, can we work towards patients and doctors (clients and therapists, healers and healees) becoming equal partners?

the answer, if there will ever be one, would be founded on a very delicate balance.

i’ll never forget many years ago, when my then 2-year-old son ran out into the street. my antiauthoritarian ideals flew out the window, i just yanked him back with all my might. in that instant, we were NOT equal – i was stronger and more experienced than him, and i’m happy of it.

what we need is wisdom in making the decision when to act in such a parental/authoritarian fashion and when we to strive our best to acknowledge the fact that ultimately, we are all equals.

can this wisdom be encapsulated in a bill of rights?

could one suggest then, perhaps, that the way to go would be for eating disorders specialists to subscribe to a general patients’ bill of rights, spelling out how that would need to be interpreted in their specific situation?

The problem of selecting groups to champion rights is to ignore the entire picture of medical care. An analogy would be what is happening in the bioethics community. There is much discussion amongst ethicists about individual bedside issues such as when to terminate life support or what to advise regarding a brain dead pregnant woman but containing a live pre-mature fetus. But where is the widespread discussion and emphatic ethical education of the politicians and public about the inadequate access to medical care for all peoples in the United States but also in countries throughout the world? Rights to proper medical management should be available to all groups (that’s the ethical principle of justice) and not just to those with eating disorders. ..Maurice.

let me just say something about the practical aspect.

let’s say psychiatrist X says to her patients, i subscribe to this bill of rights.

would this constitute a contract, and, if the patient felt that one of the rights was violated, would she have recourse before the law?

even more complicated, what if she wanted to claim one part of the bill of rights but was not in agreement with another part? would she still have recourse regarding the other?

(i think that’s one of the flaws with this bill of rights – it’s ONE package but it gives rights to a variety of people).

let’s see whether legal bloggers can help us with this …

I would just say that Kadisha’s comment makes a lot of sense, as does your initial skepticism. What does it mean to declare that someone has a “right” in a sense that isn’t strictly legal?