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270: METHODS OF
TREATI NG ANOREXIC
PAT I E N T S

ɳ Question

An unbearably difficult question has found its way to me and also
to the administrator of the clinic in the Ashkelon area. Both of us
received visits to our clinics from the families of two patients who
suffer from anorexia nervosa, a life threatening disease, with death
rates among untreated patients of up to 20%-30%. In these cases, pa-
tients, whose judgment is impaired, worry about gaining weight, even
though their present body weight is extremely low. They deliberately
refuse to eat and starve themselves, sometimes to the point of death.

To date, there is no legal provision for recognizing these patients
as sufferers from a psychiatric disorder like any other and there is no
legal way to hospitalize them forcibly when they endanger their lives.
The reason for this – as the Head of the Department of Psychiatry at
Soroka Hospital told me – is that a number of years ago two patients
who had been forcibly hospitalized sued the system for a huge sum.
He added that in his opinion there is no question that these people
are considered complete imbeciles in this respect. Since they are in-
telligent people and they often refuse treatment and there is no other
way of persuading them, it appears that practically speaking there is
no legal way to save them without using force. Their families plead for
help for their loved ones but without any backing from the law when-

224 1 Medical-Halachic Responsa of Rav Zilberstein