Judge authorizes force feeding of severely anorexic patient

A Quebec Superior Court judge has authorized a Quebec City hospital to force feed a young woman suffering from such severe anorexia that her doctor says she fears weight gain more than death.

The July 19 decision from Justice Lise Bergeron allows the force feeding of a 20-year-old woman for a period of 60 days.

She was admitted to the emergency room at the Centre hospitalier de l'Université Laval July 9, when she hit an all-time low weight of 32 kilograms, about 70 pounds. Her body mass index (weight relative to height) at the time was 12. 

A healthy body mass index is considered to be between 18.5 and 24.

The woman's psychiatrist, Dr. Marie-Julie Cimon, testified that the woman was suffering severe anorexia nervosa.

"In a state of malnutrition such as this, the brain is also malnourished, and the fear of dying has given way to fear of weight gain," Cimon testified.

The decision points out the woman has been treated for various mental health problems, including an eating disorder, since 2012.

'Obsessed with weight loss at all costs'

The hospital had already obtained a court order July 12 allowing the hospital to force feed the woman for a period of seven days.

During that court hearing, Cimon testified that the woman's extreme weight loss was endangering her life, and that she was suffering from hypothermia, slow heart rate and hypoglycemia. 

Cimon estimated that without intervention the woman would likely die within 12 to 24 hours.

"Her mental state has also deteriorated and slowed down. She's unable to deal with her obsession with weight loss at all costs. She never stops exercising and refuses to eat anything, and refuses to take any medication," Cimon wrote in a report submitted to the court.

Cimon wrote that the woman is unable to make clear decisions about her treatment.

"She is clearly unfit, and unable to recognize her disease," Cimon wrote.

Treatment plan would improve her health, doctor says

Following that seven-day period, Cimon and the hospital returned to court to ask for the authorization of a treatment plan without the woman's consent for a period of 60 days.

The plan would include administering medication to treat the woman's hypothermia, hypoglycemia and slow heartbeat, and allow doctors to provide "care related to her diet and hydration, including the use of solutions and/or force feeding".

Cimon testified that she felt this treatment over a period of two months would allow the woman to gain about a kilogram a week.

"This would bring her into a state that could allow her to talk to her treatment team, make choices with them, and re-evaluate the situation," Cimon said.

Bergeron authorized the plan, saying that "the evidence is clear that the defendant is in danger of death if the care ceases."