This paper argues that there is a relationship between understandings of anorexia nervosa (AN) and how the ethical issues associated with involuntary treatment for AN are identified, framed, and addressed. By positioning AN as a construct/discourse (hereinafter “AN: the diagnosis”) several ethical issues are revealed. Firstly, “AN: the diagnosis” influences how the autonomy and competence of persons diagnosed with AN are understood by decision-makers in the treatment environment. Secondly, “AN: the diagnosis” impacts on how treatment and treatment efficacy are defined (...) and the ethical justifiability of paternalism. Thirdly, “AN: the diagnosis” can limit the opportunity for persons with AN to construct an identity that casts them as a competent person. “AN: the diagnosis” can thus inherently affirm professional knowledge and values. Postmodern professional ethics can support professionals in managing these issues by highlighting the importance of taking responsibility for professional knowledge, values, and power and embracing moral uncertainty. (shrink)

Anorexia can be characterized as a profound transformation in social relations. These transformations occur across a number of overlapping fields, and include a range of institutional and domestic spaces and myriad mundane bodily practices in each. Through an examination of household space and a conventional treatment programme this article demonstrates the ways in which people with anorexia use and transform space. While there are many treatment programmes available for those with a diagnosis of anorexia, the ethnographic focus here is on (...) those who have undergone bed programmes in public hospitals. As a result of the particularities of time and space, these rooms are transformed into intimate spaces that represent domestic bedrooms, thus fundamentally changing the nature of shared space in institutionalized settings. These transformations, however, are not straightforward, for these bedrooms fuse a number of bodily practices (such as eating, sleeping and abluting) that are sharply demarcated in domestic architecture. In these hospital bedrooms, private and public space is conflated, reversed and made ambiguous. Moreover, this article argues that this institutional transformation of space reproduces many of the private practices associated with anorexia, a factor which has been overlooked in the recorded failure of these types of programmes. (shrink)