Decision making in patients with anorexia nervosa: a bioethical and methodological challenge

Abstract

The refusal of patients with anorexia to undergo medical treatment may create strong ethical dilemmas for health professionals, obliging them either to accept decisions that leave patients at risk or to apply treatment against their patients' will. In this paper we discuss the issue of mental capacity in patients with anorexia who consent to or refuse a specific treatment. We also review personal identity as an important factor in decision-making and discuss three decision-making styles: the subjective criterion, substituted judgment, and the best interest principle, and highlight the serious challenges associated with each one.