Your Body Deserves More

A case study for Bare Naked Ladies at JMU

Created by Lizette Zambri, Christina Mohl, Elizabeth Herring, Nicole Brice, and Cayla Ebbecke.

 

Case Study:

One Monday, at a Bare Naked Ladies’ meeting, the club focused on eating disorders along with the signs and symptoms associated with the different types. After the meeting ended a new member, Sally, was walking back to her car with Julie, a current member. While walking Sally confesses that in high school she struggled with anorexia nervosa, but feels she is managing much better now. Julie asks if she would be comfortable sharing her story at a meeting, but Sally declines and begs Julie not to say anything. As Julie gets to know Sally better and they hang out more, she thinks she begins to see signs that Sally isn’t managing as well as she claims. She starts to look tired, weak, thin, and is wearing hats more often than when she first joined. During a meeting, Sally is offered food and respectively declines at first, but when she’s asked again, Sally becomes agitated and refuses again more rudely than before. Julie starts to notice that Sally is becoming withdrawn and wonders how she should approach the situation with Sally. She has the opportunity to seek guidance from others but does not want to betray Sally’s trust and does not know for sure that Sally has relapsed. Julie worries she might be wrong and does not want to assume the worst.

A couple months later, after a Monday meeting, Julie stays behind and expresses her concerns to the executive members. She tells them what she has observed in Sally as well as her worry that Sally may have relapsed, and asks what they think she should do. The executive members talk amongst themselves after hearing Julie’s concerns and can’t reach a consensus. Half of them members feel that Sally’s symptoms could be a result of stress and that approaching her with an accusation of anorexia would be insensitive and that they are not qualified to make that kind of judgement. The other half feel that there is enough cause for concern to approach her about the issue and intervene to get her help.

Importance of Our Case Study:

Our case study is important because the prevalence of eating disorders on college campuses is high, especially among college women. 58% of college are girls feel pressure to be a certain weight (ANAD). Along with the pressure, many women feel that suffer from these disorders do not get the help they need and end up in the hospital or dying. Many women do not know how to get help or how to help a friend who they feel is suffering. In our case, we explore the options available when facing the dilemma of trying to help a friend you might think is in need. Eating disorders have the highest rate of mortality of all mental illness, yet is not always in the forefront of college conversation. We aim to bring this discussion to life and hope to arm someone who is faced with this dilemma with the tools they will need to come to a decision that feels right for them.

Goal of Case Study:

With this case study, we hope to improve the self efficacy of Bare Naked Ladies members in reaching out to other members when they are concerned about their health. We also hope to further spread awareness about disordered eating and create a community prepared to handle the ethical decisions involved in confronting someone with an eating disorder, rather than being a bystander.

Further Discussion:

• What are the concrete facts of this case and what are implied?

• If this scenario happened in your organization, what duties or obligations would you feel to help make an ethical decision?

• How does this situation translate into an ethical dilemma?

• How does Bare Naked Ladies mission relate to the dilemma shown today?

• What if Julie did not tell Sally’s secret but instead wanted to approach her family, how would this change the dilemma she’s facing as a friend?

• Using the Eight Key Questions, decide which one would make the most sense to you in this scenario and explain how it helps choose which path is the most ethical.

• What if Sally was not a member of Bare Naked Ladies but Julie was, how do you think that would change the decisions of the executive board?

Decision Making Models:

Utility Model

Step 1: Identify the alternative actions that are possible and determine who would be affected by the decision.

• Do nothing - this would affect Sally, the Bare Naked Ladies, Julie, and Sally’s parents.

• Call Sally’s Parents- this would affect Sally, the Bare Naked Ladies, Julie, and Sally’s Parents.

• Talk to Sally directly- this would affect Sally, the Bare Naked Ladies, Julie, and Sally’s Parents.

Step 2: For each alternative determine the costs and benefits for each of the groups affected.

• Do nothing- This respects Sally’s desire for privacy, it also makes the Bare Naked ladies bystanders to any negative consequences Sally may face, it may preserve Sally and Julie’s friendship, doing nothing also keeps Sally’s parents in the dark.

• Call Sally’s Parents- This violates Sally’s desire for privacy, but it alleviates the responsibility from the Bare Naked Ladies preventing them from being bystanders, this could cause a strain in Sally and Julie’s friendship since Julie violated Sally’s trust, this would include Sally’s parents in the decision making as they have intimate knowledge of Sally’s history with an eating disorder.

• Talk to Sally directly- This violates Sally’s desire for privacy, it also makes the Bare Naked Ladies active participants in Sally’s health giving them some responsibility for her outcomes while possibly pushing Sally away, this could cause a strain on Sally and Julie’s friendship since Julie violated Sally’s trust, this approach also keeps Sally’s parents in the dark.

Step 3: Select the action that produces the greatest benefits over burdens for everyone effected.

• Calling Sally’s parents gives the greatest benefit over burden.

Step 4: Predict the consequences of the action for all similar situations.

• Calling Sally’s parents could result in them getting her help while she finishes out college, it could also result in them pulling her out of school to come back home, or in them not being concerned thinking that Sally has it under control.

Step 5: Make an Ethical decision.

• The Bare Naked Ladies should call Sally’s parents with their concerns.

Step 6: Monitor the results of the decision and repeat the process as changes occur.

• Does Cost:benefit stil create the most good for the parties involved?

Analysis: A strength of the utility model is its focus on outcomes for all parties involved. For this case study the outcomes of concern are Sally’s health, Sally and Julie’s friendship, and Sally’s parents right to know about their daughter’s health. A weakness of this model is its reliance on an accurate probability assessment, or picking the most likely outcome. Without all of the facts it is hard to know how Sally’s parents might react to a phone call from a campus organization.

 

Virtue Model

Step 1: Determine whether the situation helps you to or hinders you from becoming the type of professional you most want to be .

• If the women on the executive board of Bare Naked ladies decide to confront Sally on her suspected problem, it would help them be the best version of women in power or health professionals if that’s the path they are going down. If the suspicion has become overwhelming and they feel they need to act, that could be considered the most responsible decision on behalf of Sally’s health and safety, since they are in a position of power being the executive board of an organization whose mission is body positivity and loving the skin you’re in.

• If the women decide not to confront her, it could be seen as being the best versions of an executive board because they are not intervening based on hearsay, but are instead waiting for Sally to come to them if she has a problem.

Step 2: Establish whether the situation corresponds to the industry’s reputation or vision of what it would like to be. This image is explained in health care providers’ mission and vision statements, the core values and the ethics code.

• Since the women are part of Bare Naked Ladies, their mission is to spread healthy body image, body positivity, self-confidence, and loving natural beauty. If they think Sally is not upholding these ideals or has strayed from a healthy body image, it is their duty to help her see herself in a positive light and have a healthy body image.

• The mission of Bare Naked Ladies is to spread body positivity and healthy body image but it does not say anything about confronting other members if they think they may have an eating disorder. It is their duty to promote these ideals but not to implement them on other women.

Step 3: Ascertain whether the situation improves the delivery of high-quality, equitable health care

• Some of the executive board feel that they should intervene, and if they do it could improve Sally’s overall health, if she indeed has relapsed like they suspect. If she does have a problem again, she can get professional help and recover if the women decide to talk to her privately and ask if she needs help taking the next steps.

Step 4: Make an ethical decision. Actions that correspond to the virtues most people in the healthcare industry want to be associated with are ethical.

• The executive board should step in to fulfill their duty as Bare Naked Ladies executive members. Exec is supposed to uphold the mission of the organization the most and if they want to do so, they should confront Sally and try to help her. There is a chance that she has not relapsed, but the suspicion alone should be addressed so the women know that they did what they could to help their fellow member.

Analysis: The strengths of this model are that it makes the executive members remember their mission and challenge them to uphold those ideals. If they want to be the best members of a body positivity group, they need to be willing to confront one another if they suspect that another member is not living up to that ideal. A weakness is that not of all the executive members feel this path is upholding the ideals of Bare Naked Ladies. Some might think they are shaming a member if she has lost some weight or if she has another condition they don’t know about, it could be putting Sally’s appearance down unintentionally. Some might think that their only mission is to promote body positivity and healthy body image, not to question other members or women and intervene in their lives.

Monitor

• Is this the best version of a Bare Naked Lady these women can be? If not then the choice would have to change but the choice made would have to continue to uphold the values of Bare Naked Ladies.