ABSTRACT
Anorexia nervosa has among the highest mortality rates of all mental ill-health. Researchers have recently identified a cohort of individuals who suffer a severe and enduring course of ill-health for whom continued aggressive, even involuntary treatment, may be considered futile and a palliative approach more clinically appropriate and ethically justifiable. This chapter presents the arguments for and against the application of futility judgments in medical versus the psychiatric condition of anorexia nervosa. The key role of decisional capacity in individuals declining to pursue further active treatment is examined as are the different valence each side attaches to the core ethical principles of autonomy and nonmaleficience. The chapter concludes with areas for further study that may clarify the many unanswered questions regarding the ethics of end-of-life are for persons experiencing severe and enduring anorexia nervosa.
