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Reality TV and Eating Disorders Part III informed consent issues

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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.)

Comments  

Shelly
0 # Thank you so much for bringing awarenessShelly 2010-05-12 11:23
Thank you so much for bringing awareness to this. I have linkied your blog to our FB group. Please join or fb group as we advocate for these shows to be stopped.

FB group: Stop Reality TV shows from exploiting Eating disorder patients."
pinkjoanna
0 # Dear Shelly, Thank you for letting mepinkjoanna 2010-05-12 11:47
Dear Shelly,

Thank you for letting me know about the Facebook group. Please send me a url to find it. The FB search couldn't find the title you enclosed.

warm regards,

Joanna
PTC
0 # I just read that Oprah is going to havePTC 2010-05-13 18:55
I just read that Oprah is going to have a show about eating disorders on her new network. Okay, I've cleary been in a coma or something because I didn't even know Oprah was launching her own network. Anyway, I know most people are not happy to hear about this show, "Inside Rehab," which take the cameras inside an ED treatment center. I, for one, can NOT wait to see this show when it starts airing next January. Would I want to be on tv if I were in a treatment center? Hell no. Do I necessarily agree with having cameras in these types of facilities? Probably not, but I'm glad they're doing it so I can watch it. I love ED stuff.
PTC
0 # Ha, I was wondering why you had the OpraPTC 2010-05-14 04:17
Ha, I was wondering why you had the Oprah picture up when you first posted that other post. I guess maybe I should read things! :-)
susie user
0 # I don't see an Oprah picture...susie user 2010-08-25 16:44
I don't see an Oprah picture...

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JoannaPoppink It's Time for Universities to Stop Being "Neutral" About the Climate Crisis https://t.co/fCnZsNY9En
41mreplyretweetfavorite
JoannaPoppink Latest Sustainable World online now. https://t.co/UQgtAXMxXI Thanks to @molecologist @NRDCnews #climate #elemed
41mreplyretweetfavorite
JoannaPoppink The hotter the planet grows, the less children are learning https://t.co/9fe4vsSnT1 by @newshour
13hreplyretweetfavorite
JoannaPoppink Latest Sustainable World online now. https://t.co/mMILHcmvzk #climatecrisis #actonclimate
13hreplyretweetfavorite
JoannaPoppink Wow. I got too little sleep last night and took it easy at home today. Now find this. Sleep deprivation needs to… https://t.co/W0l5MxOWJm
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