Severe and enduring anorexia nervosa and futility
Abstract
The concept of futility in the treatment of individuals with severe and enduring anorexia nervosa remains controversial and has significant legal and ethical considerations. For those who have been unremittingly ill for 8 to 12 years, full recovery, although possible, is unlikely, and alternatives to traditional, active treatment must be explored. The harm reduction model, palliative care, and end-of-life care are explored as meaningful and reasonable treatments for this population. Landmark cases demonstrating the legal and ethical controversy of such treatment are explored.
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Futility refers to the likelihood of a specific treatment to benefit a patient at a particular time; it does not apply broadly to whether a patient can benefit from any treatment.
“Importantly, futility refers to the likelihood of a specific treatment to benefit a patient at a particular time; it does not apply broadly to whether a patient can benefit from any treatment (140).”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [140]
Palliative care is increasingly recognized as relevant for a minority of adults with severe and enduring anorexia nervosa who do not respond to expert intensive inpatient behavioral treatment.
“Palliative care is increasingly recognized as relevant for a minority of adults with SE-AN who do not respond to expert intensive inpatient behavioral treatment”
From Terminal anorexia nervosa is a dangerous term: it cannot, and should not, be defined (2022) · cites this paper as [7]
In a minority of adults with severe and enduring anorexia nervosa who do not respond to expert intensive inpatient behavioral treatment, continued aggressive attempts at weight restoration infringe on patient autonomy, risk harm, and may constitute futile care.
“and in whom continued, aggressive attempts at weight restoration infringe on patient autonomy, risk harm, and may constitute futile care [6, 7].”
From Terminal anorexia nervosa is a dangerous term: it cannot, and should not, be defined (2022) · cites this paper as [7]
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References 30 · Cited by 15
- Authors
- Westmoreland, P., Parks, L., Lohse, K., & Mehler, P.
- Affiliations
- Denver Health Medical Center (US)
- Corresponding author
- Westmoreland, Patricia
- ORCID
- Mehler, Philip
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 44
- Issue
- 4
- Pages
- 603-611
- ISSN
- 0193-953X (ISSN-L)
- OpenAlex
- W3211408746
- Cited by
- 15
- References
- 30
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 2
- FWCI
- 0.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- Keywords
- severe and enduring anorexia nervosa, futility of treatment, harm reduction, palliative care, end-of-life care, legal and ethical issues, treatment-resistant eating disorders, landmark court cases
- MeSH terms
- Anorexia Nervosa, Humans, Palliative Care, Terminal Care, Medical Futility, Harm Reduction
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