I realize this is a silly question, but thought I'd play devil's advocate anyway... So I read something about 'pro-ana' and 'pro-mia' culture, where people with anorexia or bulimia see themselves as having simply a different mentality rather than a sickness. Now, that makes me as sick as the next person, but think about it. If those young women are older than 18, and they understand exactly what they are doing to themselves, does that really count as a sickness? If you know that you are risking osteoporosis and other lovely stuff by keeping your body weight so low, but you are willing to accept that risk because it makes you happy...how is that any different from, say, doing a dangerous sport or ingesting too much caffeine? I know if I do a precision jump on to a narrow wall I might end up in A and E, but I choose to do it anyway. Should that be called a sickness too? Basically...Where is that line that makes something a sickness?
Irregardless of whether or not you choose to define that type of behavior as a "sickness" or mental illness, such behavior is inarguably harmful and prevalent. Medical professionals devote their careers to treating people who are considered anorexic and/or bulimic because there is a demand for treatment. Whether or not you agree with defining the behavior as a sickness of simply a different mentality is ultimately inconsequential. A similar argument exists when discussing addiction. Many professionals classify addiction as a disease yet there are others who argue the point you've made. Illnesses of the mind are much harder to rigidly define when compared to physical afflictions.
That's what I'm trying to get to the nucleus of. Should an otherwise rational person be forced to undergo treatment, if they're not actually endangering their own life, because someone thinks she should weigh 50kg rather than 42??
Good point. So (this is addressed to everyone) What do you think are the criteria of a real sickness, and not just someone making a choice that makes other people's insides feel weird??
But you're not being consistent. In the title of your thread you cite this behavior as "self destructive," but then in this post you insist that "they're not actually endangering their life." Which is it??? The survival instinct is one of the defining characteristics of life. Organisms that don't have it will not live to reproduce and the species will become extinct. Obviously in a pack-social species like Homo sapiens, we're all programmed to sacrifice our lives for the good of the pack, but this is a rational sacrifice that promotes the survival of the species. To endanger your life for an eccentric concept of physical beauty reduces the probability of survival and therefore is legitimately regarded as a disorder. Of course there are "borderline" anorexics and bulimics in show business and the fashion industry, people who lose just enough weight to qualify for employment, which enables them to buy food, pay rent and survive. But this is hardly the profile of the typical non-professional anorexic or bulimic. The majority of them reduce their food intake to the point that they cannot metabolize the MDAR of many important vitamins and minerals, even if taken as supplements. In addition, bulimia brings all the detrimental effects of GERD as well as being really hard on the teeth. These behaviors will not cause the quick death that would come from resolute overdosing on drugs or rock climbing without a helmet and safety lines, but they will greatly reduce life expectancy. I challenge anyone to name a 75 year-old anorexic or bulimic. Or even one my age (66) who's been doing it for more than a couple of years. Now personally, as a libertarian, I believe that everyone should be allowed to live their own life the way they want and take the risks they want to take, regardless of my estimate of their rationality, so long as they cause no direct harm to others. Who am I to judge how much pleasure or other satisfaction a person gets from their particular course of action? If I had a friend who was anorexic (and in fact I have one whom I wonder about), I would noodge her about it mercilessly (and I do), but I would not drag her off to an involuntary recovery program (and I haven't). If she were a member of my family, then that's different. The dynamics between family members are undefined, everyone works it out for themselves. Still, although I would pay for her psychotherapy and drive her to the sessions to make sure she didn't skip them, I wouldn't hire someone to kidnap her and confine her in a clinic.
I don't think we need to call the patterns a sickness, even if we think they are self-destructive? Is free climbing a sickness? free diving? are all risktaking activities sicknesses? Is watching too much TV a mild sickness? Is eating fast food regularly as sickness? I think the medical model creeps into areas it should not and there are several reasons for this. It can make some people money. It moves responsibility away from the person. I mean we tend not to get pissed off at people who catch a cold. Bulimia and anorexia are damaging patterns.
It seems that people for the most part readily decide for themselves whether they think something is a sickness or not, without giving it much thought (or allowing for much thought from others). For example, there are people who believe that all people who are obese are simply lazy overeaters; they do not accept that there may be medical conditions which manifest as obesity. The only ones who are really concerned about the definition of sickness are politicans, law makers, and all those who have some profit to gain or lose if some phenomenon be defined as a sickness or not. Personally, I do not care whether some condition I might have is called a sickness or not; I am only concerned about the consequences of reporting it to a doctor, agreeing to a treatment, and how all this may look on my medical record, given that my aim is that my medical record looks as unproblematic as possible.
Sorry, I should have chosen my words more carefully. I was using 'self destructive' in a general sense to mean something that is bad for you. That is my view too. (highlighted in bold).
The problem is that even if what you do causes no harm to others it could cause harm to others indirectly. Say you wanted to take a risk at skateboarding behind a truck that you held onto a rope with being pulled along. Then something happens and you hit a bump in the road going 30 MPH and crash into the pavement breaking your spine. You are taken to a hospital where millions of dollars are spent trying to help you get yourself back together again. That money could have been spent on someone who really didn't do stupid things in order to be "different". So you always hurt someone somehow whether you may not think so.
And who gets to define 'doing something stupid'? I wouldn't say someone who falls off their skateboard is less deserving than someone who injured themselves fixing a lightbulb. I don't see that as doing something silly. I think any sport that involves that degree of challenge is something worth doing, not childish.
You're talking to a libertarian here so your argument carries no weight. The average American's lifetime contribution to the GDP is somewhere in the seven-figure range. (I'm not going to try to track down an elusive figure like that right now.) So the rational decision for society to make is to let him die and forgo his contribution, rather than spending a larger sum of money that he will very likely never compensate us for. The alternative strategy of course is to sell him "idiot insurance." Besides, we libertarians do not wave away the possibility of indirect harm. We just think it should be litigated. If my loud music disturbs your horses so they don't breed, then the judge should require me to pay you a reasonable restitution for your loss. And yes I know that the world is not so easily divided into neat little categories. I'm not a paleolibertarian or an anarcholibertarian--in fact I'm one of the rare breed of leftist libertarians--so I accept the need for compromises. I just don't believe that anorexics and bulimics cause enough indirect harm to anyone to give us the right to confine them involuntarily and stuff them with creme brulee.
