First, do no harm: the proposed definition of “terminal anorexia” is fraught with danger for vulnerable individuals
Open accessAbstract
A recent article in the Journal of Eating Disorders (10:23, 2022) proposed criteria for "terminal anorexia" with a cited goal of improving access to end-of-life care (Gaudiani et al. in J Eat Disord 10(1):23, 2022). The authors presented three cases in which patients received end-of-life care, including the prescription of medical assistance in dying (MAID), also known as physician-assisted suicide (PAS). The proposed criteria lack the evidence base for adoption and do not acknowledge the compelling evidence that exists surrounding possible prolonged timelines to recovery for some individuals and the nuances of assessing capacity in this population.
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Some jurisdictions now allow assisted dying for reasons solely related to a psychiatric disorder.
“Some jurisdictions now allow assisted dying for reasons solely related to a psychiatric disorder”
From Assisted death in eating disorders: a systematic review of cases and clinical rationales (2024) · cites this paper as [4]
The Abstract discusses medical assistance in dying in cases of anorexia, and ‘The lack of objective data to define terminality’ discusses terminal diagnoses. Neither section says whether any jurisdiction permits assisted dying solely for a psychiatric disorder; searches for jurisdictional rules and psychiatric-only eligibility found no such passage. (LLM, conf=0.72)
Experimental — accuracy not yet measuredClinicians who treat anorexia nervosa cannot predict who will recover or when, nor identify those who will not be able to survive.
“This critical appraisal rightly asserts that clinicians who treat AN cannot predict who will recover or when, nor identify “those who will not be able to survive”, as most medical complications are reversible with nutritional rehabilitation and expert care.”
Most medical complications of anorexia nervosa are reversible with nutritional rehabilitation and expert care.
“This critical appraisal rightly asserts that clinicians who treat AN cannot predict who will recover or when, nor identify “those who will not be able to survive”, as most medical complications are reversible with nutritional rehabilitation and expert care.”
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Cites
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Cited by
Sorted by citations
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- Authors
- Riddle, M., O’Melia, A. M., & Bauschka, M.
- Affiliations
- University of Washington (US)
- University of Utah (US)
- Corresponding author
- Bauschka, Maryrose
- Venue
- Journal of Eating Disorders
- Published
- 2022-06-16
- Volume
- 10
- Issue
- 1
- Pages
- 81-81
- ISSN
- 2050-2974 (ISSN-L)
- PMC
- PMC9202193
- OpenAlex
- W4283031613
- Cited by
- 25
- References
- 14
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 8 · 2023: 6 · 2022: 1
- FWCI
- 4.57
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Journal of Eating Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- 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
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- anorexia nervosa, end-of-life care, medical assistance in dying, physician-assisted suicide, definition criteria, vulnerable individuals, recovery timeline, decision-making capacity, harm reduction
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