Reality TV and Eating Disorders Part III informed consent issues
- Category: Culture and Media
Years ago, when the issue of "informed consent" was first brought up, I attended many gatherings of experienced mental health clinicians in Los Angeles where we discussed what the term really meant.
Signing an agreement did not, we decided,meet the standard of informed consent if the person were incapable of being informed. I doubt that people with eating disorders understand the full significance of what they are getting into with these reality TV shows. Part of informed consent, in my opinion and using the American Medical Association guidelines as a model, would include a knowledgable person legally and ethically responsible for the content of the show to:
know each auditioning person's diagnosis, the ramifications of that diagnosis and thoroughly discuss that information with the individual involved;
understand and describe fully to the individual the nature and purpose of the proposed "procedure," i.e. details and purpose of the reality show;
clearly state the risks and benefits to the individual related to being involved at any level in the creating, auditioning, publicity and participating in the reality show.
describe fully the alternatives to participating in the show (regardless of their cost or the extent to which the treatment options are covered by health insurance);
thoroughly describe risks and benefits of these alternatives;
thoroughly describe the risks and benefits of not being involved with the show on any level
allow ample and open time for the individual to ask questions in order to fully understand the issues at stake.
have competent and informed people legally and ethically representing the show and the network who are capable of thoroughly answering those questions.
Eating disorders take years to develop and years to overcome. An informed consent agreement would have to be open-ended and cover consequences that could develop over many years. To be fair and realistic in terms of a participant's welfare, the producers of the program or the network would remain financially responsible for any difficulties that occurred to peoplel as a result of being followed so intimately on camera. By this I include hardships to family relationships that develop between participants and spouses they have not yet married, children not yet born and professions not yet entered. The full consequences of being on followed on a reality TV show can affect a person for a lifetime. That needs to be understood and acknowledged.
I also think a disconnect exists when society or the public or the legal world can say that people with eating disorders make poor judgements in terms of health, food, relationships and yet are considered competent adults who enter contracts with knowledge and understanding and therefore, have willingly put themselves into situations that are not in their best interests.
This above paragraph, I agree is open to lots of discussion. With or without their eating disorder mentality, I believe adults should have all the freedom allowed to any competent adult in our society. But that being said, the situation puts more responsibility on the mental health profession to clarify and support genuine healing work without agreeing to the sacrifice of individuals who are involved in these shows - the few on camera and the many who try out.
Whew. I didn't know I was going to write so much about this. My passion is showing. I hope you will keep this conversation going and add your point of view in the comments.
(For more information about ethical obligations, see the AMA's Code of Medical Ethics, contained in the AMA PolicyFinder.)