Is it ethical to clear and clean the home of an extreme hoarder against his will?

Question

Is it ethical to clear and clean the home of an extreme hoarder against his will?

He's an old man, ill in hospital, and badly injured by the part-collapse of his home. He has also been neglecting himself (not eating, bathing etc).

He is not allowed home from hospital unless the squalor is fully cleared.

He emphatically does not want it clearing but his adult daughters want to clear it to allow him to go home. One will then move in and become his carer.

Are the good intentions enough or is this always wrong if blatantly against his will?

Answer 1

Your question is essentially a variation on a debate in the autonomy literature. The question that arises there is the relationship between autonomy and free choices. The two examples most common in the literature are prostitution and burqas. The question in these instances and yours is this:

To what extent is autonomy to be located in the immediate will of an individual and to what extent is it located in having a well-ordered will. And then to what extent do we have a right to intervene in autonomous but poor choices.

Clearly, cleaning the house is against his immediate will. But then the question is if it is against his-all-things-considered will or his-all-things-considered good.

Here, in the case a hoarder, part of the question will be whether you consider his current cognitive function sufficiently impaired to decide whether or not can engage in autonomous acts of will. If you think he cannot engage in autonomous acts of will, then it is merely a question of whether it is right or not to clean his house.

If you think he can engage in autonomous acts of will, then the question is whether the situation warrants a paternalistic response.

---

But before you clean his house, you should consult with a counselor specialized in hoarding. Several people in my wife's family are hoarders. And from that I've learned a little bit about hoarding. Hoarding is a type of executive function disorder -- meaning that the person has a hard time deciding what is valuable and worthless. Moreover, it is often something that has an onset at some point in life and can get amped up by depression.

To put it another way, hoarding things is a symptom -- not the root issue itself. But then cleaning things for a hoarder doesn't work because the function problem remains.

Now, all that being said, if the house has become unsanitary, this all seems minor...

Answer 2

I wouldn't say they are acting against his will.

Compulsion and free will are not the same. The hoarder doesn't make a free will decision to hoard. He isn't capable of wanting the mess to be cleared up.

I think it would be unethical to clean up the house against his will (even then if he doesn't want help only because he doesn't want to burden his daughters but the daughters think it isn't a burden it could be a different situation). But in this case, they would clean up the home against the expression of his compulsion, not against his will. So unless the cleanup would actually hurt him, I think it is ethical.

Answer 3

Whom ever is not allowing him to go home, obviously has authority over the "old man"! Have the same person(s) (under the same authority), issue the order to clean and repair the home. Ethical problems (if any) for the daughters, solved! However, the hoarding problem will not be resolved unless/until the underlying (psychological) reason(s) that caused the hoarding are addressed.