Dr Stefan Goldfeder1
1Queensland Health, Wacol, Australia
Biography:
Staff Psychiatrist, Prison Mental Health Service (2023-2026) and High Secure Inpatient Service (2020-2023) The Park Centre for Mental Health, Wacol.
Abstract:
The presentation reviews complexities in the assessment and management of hunger strikers. Hunger strikes commonly cause ethical, medical, psychiatric and legal dilemmas in custodial settings. Definitions distinguish hunger strikes from food refusal though they are often conflated. We briefly explore assessment: of mental illness; motivations (such as suicide or grievance), and decision-making capacity in real world settings. Management invokes balancing autonomy, best interests and institutional (dual agency) obligations. Most guidelines respect autonomy, but authorities often resort to legal or regulatory circumventions. We consider whether and when a person who is not eating could be involuntarily treated (and involuntarily fed) with a nexus between the two. Cautions and safeguards for practitioners are considered.
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