This essay, about the concept of treatment, is written by a psychiatrist who is monitoring extreme treatment situations, namely surgical treatment of epilepsy. It challenges the implicit assumption that persons consulting doctors necessarily want to be treated. A child may not be privy to, or wish to be party to, a treatment. The child, or the parent on behalf of the child, may not agree to the course of action that is in its best interest. One problem of treatment concerns who owns the body that is to be treated. Ultimately, the body belongs to the state and is merely tenanted by the child and managed by a parent on the state's behalf. But the body must, somehow, be owned if its sickness is to be acknowledged. The lack of real autonomy provides for the possibility of abuse including abusive therapies. “Abuse” is applicable only to abuse of trust. Autonomy is granted or conceded by parents and by the state but is never complete. Autonomy is confirmed by taking informed decisions about what will happen to the body. Treatment is a cost/benefit deal in which the precise aim to be achieved has to be described and accepted before treatment begins.
