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Trust is taken to be one of the foundational values in the doctor-patient relationship, facilitating access to the benefits of health care and providing a guarantee against possible harms. Despite this foundational role, some doctors betray the trust of their patients. Trusting involves granting discretionary powers and makes the truster vulnerable to the trustee. Patients trust medical practitioners to act with goodwill and to act competently. Some patients carry pre-existing vulnerabilities, for reasons such as gender, poverty, age, ethnicity, or disability, (...) |
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Comparatively little scholarly attention has been given to the question of futility in chronic psychiatric disorders, with the exception of a small body of work on so-called end-stage anorexia nervosa. A review of this literature provides the background for a critical examination of whether the concept of futility has any clinically meaningful, ethically justifiable, and legally defensible application to AN. In this article, the arguments for and against futility judgments in AN are analyzed with special emphasis on determinations of capacity (...) |
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People who suffer from eating disorders often have to be treated against their will, perhaps by being detained, perhaps by being forced to eat. In this paper it is argued that whilst forcing compliance is generally acceptable, there may be circumstances under which a sufferer's refusal of consent to treatment should be respected. This argument will hinge upon whether someone in the grip of an eating disorder can actually make competent decisions about their quality of life. If so, then the (...) |
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Anorexia nervosa is a very serious condition because of the suffering and loss of life that it causes. However, the wishes of the people directly involved can be strongly opposed. The person with severe AN may not want treatment, yet her family beseeches professionals to unilaterally intervene and clinical teams are divided over the defensibility of involuntary hospitalization and treatment. The metaphor of a crucible is used in this paper to help identify how much is at stake and how much (...) |
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Anorexia nervosa is a very serious condition because of the suffering and loss of life that it causes. However, the wishes of the people directly involved can be strongly opposed. The person with severe AN may not want treatment, yet her family beseeches professionals to unilaterally intervene and clinical teams are divided over the defensibility of involuntary hospitalization and treatment. The metaphor of a crucible is used in this paper to help identify how much is at stake and how much (...) |
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