Compulsive Hoarding - Ethical Decision Making On Television Reality Shows Exposing Hoarding Disorder

Compulsive hoarding disorder and other psychological pathologies are now being exposed

on reality TV and marketed as entertainment or even education.

In these programs the ethical decision making process seems to proceed along the path of the moral reasoning theory that is a simple risk analysis of impending danger versus the opportunity for free help.

Is that line of moral reasoning the one that should be used by the professionals involved and is that approach really helpful to the compulsive hoarder or clutterer? And further, should the offer of free help or help of any kind supersede the obligation of the professional to protect the hoarder's dignity and worth as a human being?

These reality television shows always start out with various panoramic views of a cluttered home. Some situations are so extreme there are serious health issues in the environment. Many times the environment is not fit for human habitat. Animal and human waste, rotting food, dirt, piles of clutter and garbage impede access and any sort of normal living in the hoarder's home environment.

Such pictures make it easy to jump to the conclusion that the hoarder who lives there must be a messy person and if only they could get their act together and overcome laziness they could at least have a healthier living environment. Further explorations however, reveal serious psychological and emotional pathologies which sometimes include substance abuse. A recent episode profiled a young man who kept threatening suicide if things did not improve. Living with his alcoholic father he was seriously affected by his environment and was aided in getting through the panic attacks that accompanied the clean up by the psychotherapist involved.

The ethical issues in these situations seem not to be considered by either the television producers or the therapists involved. It is obvious that their ethical decision making abilities are greatly influenced by the ability to make money and the strong rationalization that they are working in the best interest of the hoarder because they are providing help that might not otherwise be forthcoming. In this case philanthropy appears to be more important than protecting human dignity and privacy. In other words the helpers value the opportunity to "do good" more than they value the worth and dignity of the people they are supposed to be helping.

All ethical decision making proceeds along the path of the moral reasoning theory that is used to decide right and wrong.

In the case of these reality TV shows, it appears that if there was any ethical decision making done at all, it proceeded along the lines of a risk analysis and simply balanced off the possible risks to the compulsive hoarder with the benefits that might be achieved by helping them "clean up" and "let go".

Using this line of moral reasoning the conclusion would be that inviting the hoarder to participate in the televised expose is the right thing to do because it prevents impending situations of eviction or as in the case of the young man mentioned, a possible suicide. Surely any act that helps the hoarder out is the "right" or morally good act?

However, in order to get this help and to avoid the impending "bad" situations that are on the hoarder's doorstep, there has to be an agreement to enter into a helping relationship with the therapist and a financial relationship with the producers of the show. The problem is that these relationships may in fact be in conflict and will certainly expose choices, co-dependencies and pathologies. The helping relationship is supposed to exist for the benefit of the client and not exist in the interests of entertainment and making money.

Now the question is: "Is it a right or morally good action to make these exposes by using people who are vulnerable?" I seriously question that it is.

Another line of moral reasoning can lead to quite a different decision about what is right and wrong in this situation. In this model of ethical decision making and reasoning, the action itself and not the outcome is evaluated. So instead of asking what is the outcome of this action the questions become:

*What is my duty or obligation in this case?

*To whom or what principle must I remain true?

*What rights do the people involved have and whose rights supersede the rights of of others?

In the case of the professionals and therapists involved in these types of reality television shows if these questions were answered they may find that participating in the show is not ethical because the very people they are supposed to protect may in fact be harmed by the shame and ridicule that comes from exposing such vulnerabilities and pathologies.

Compulsive hoarding is deeply rooted in issues of shame, low self esteem and emotional deprivation. Psychiatric pathologies such as obsessive compulsive disorder (OCD) and substance abuse are often present. Exposing these matters on national television cannot be helpful in improving feelings of self worth.

Is a television show really the morally right or morally good action necessary to get the hoarder the help they need?

by: Beverly OMalley

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