I think it is murder. Slow murder that has been going on for years with many accomplices, with the judge as the last. To hospitalize without restoring normal health, to depend on the mentally ill patient's insight and motivation, and to believe the real person in there "wants" to die: these are crimes. Unwitting crimes, I know, but we would do better for someone in a coma. In fact, we do.
This is all a basic misunderstanding of the nature of anorexia nervosa, which robs patients of insight and motivation just as a coma robs the patient of consciousness.
If they "allow" her illness to kill her they are making themselves more comfortable, not her -- she only gets one life and it is not her fault or choice that they've failed her so thoroughly for so long that THEY have run out of options. Or really, WE have.
These half-lives and deaths are our fault. Time to step up, folks. We need to change the public view of anorexia, the healthcare policies, the legal barriers, and our own personal fears.
These patients need our help, all of us, and we're failing them.
Anorexia is not a choice.
Being unable to eat is not a choice.
Having symptoms of social withdrawal and food phobia and obsession and body dysmorphia and binging and purging are NORMAL AND EXPECTED for those who are malnourished.
For those with a predisposition for an eating disorder NO amount of malnourishment is acceptable.
Simple short-term re-feeding is not enough
The patient doesn't need to understand why, be motivated, or cooperate.
They are ill: what's our excuse?
Without the entire ED community coming together, LOUDLY, none of this will change. But the truth is that most of the ED community doesn't understand eating disorders and are part of the problem. All the attention to self-esteem and loving one's body and Size Zero models and wanting to be thin: it's a distraction. All the talk of "control" and "having no voice" and "attachment" are also distractions.