The Ethical Defensibility of Harm Reduction and Eating Disorders

Bianchi, Andria; Stanley, Katherine; Sutandar, Kalam

doi:10.1080/15265161.2020.1863509

Cited by 41Eating Disorders and BehaviorsEthics and bioethics in healthcareEthics in medical practice

The Ethical Defensibility of Harm Reduction and Eating Disorders

Bianchi, Andria, Stanley, Katherine, Sutandar, Kalam·2021·The American Journal of Bioethics

DOI 10.1080/15265161.2020.1863509

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Abstract

Eating disorders are mental illnesses that can have a significant and persistent physical impact, especially for those who are not treated early in their disease trajectory. Although many persons with eating disorders may make a full recovery, some may not; this is especially the case when it comes to persons with severe and enduring anorexia nervosa (SEAN), namely, those who have had anorexia for between 6 and 12 years or more. Given that persons with SEAN are less likely to make a full recovery, a different treatment philosophy might be ethically warranted. One potential yet scarcely considered way to treat persons with SEAN is that of a harm reduction approach. A harm reduction philosophy is deemed widely defensible in certain contexts (e.g. in the substance use and addictions domain), and in this paper we argue that it may be similarly ethically defensible for treating persons with SEAN in some circumstances.

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Person-centred recovery and harm-reduction approaches may be particularly beneficial for individuals with SE-AN, and recovery-model approaches for SE-AN may benefit both patients and clinicians.
“Person-centred recovery and harm-reduction approaches may be particularly beneficial, especially for individuals with SE-AN [140–142], and recovery-model approaches for SE-AN may benefit both patients and clinicians [143].”
From A lived experience response to the proposed diagnosis of terminal anorexia nervosa: learning from iatrogenic harm, ambivalence and enduring hope (2023) · cites this paper as [140]

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Authors: Bianchi, A., Stanley, K., & Sutandar, K.
Affiliations: University Health Network (CA)
University of Toronto (CA)
Corresponding author: Bianchi, Andria
ORCID: Bianchi, Andria
Venue: The American Journal of Bioethics
Publisher: Informa UK Limited
Published: 2020-12-28
Volume: 21
Issue: 7
Pages: 46-56
ISSN: 1526-5161 (ISSN-L)
1536-0075
DOI: 10.1080/15265161.2020.1863509
OpenAlex: W3114320833
Cited by: 41
References: 32
Citations by year: 2026: 9 · 2025: 5 · 2024: 14 · 2023: 5 · 2022: 3 · 2021: 5
FWCI: 1.30
Type: journal article
Language: en
Open access: closed
Locations: The American Journal of Bioethics (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
Keywords: harm reduction, eating disorders, anorexia nervosa, severe and enduring anorexia nervosa, treatment philosophy, recovery, psychiatric treatment
MeSH terms: Anorexia Nervosa, Feeding and Eating Disorders, Humans, Morals, Substance-Related Disorders, Harm Reduction

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The Ethical Defensibility of Harm Reduction and Eating Disorders

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