Ethics

STEPHEN TOUYZ, University of Sydney
TERRY CARNEY, University of Sydney - Faculty of Law
This chapter concentrates on the medical and ethical turbulence regarding management of anorexia nervosa at that intersection between law and medicine. While not overlooking the emerging literature on ?when? and ?why? clinicians actually invoke whatever powers the law permits, our emphasis is on the issues of principle at stake. The chapter reviews the diverse pattern of laws (if any) which may be used in aid of involuntary treatment of anorexia nervosa suffers in different jurisdictions, before setting out some of the ethical principles informing the use of involuntary treatment. The main section of the chapter then examines the clinical practice and therapeutic role of coercion within the overall treatment options for dealing with a condition whose chronicity, morbidity and mortality rates understandably puts pressure on clinicians to find ?solutions?. The chapter concludes by arguing that coercion into treatment has a very limited, but potentially vital, role to play in dealing with anorexia patients presenting with life-threateningly low Body Mass Indices (BMI?s) or equivalent compromise of their current or future health status.