Ethics in eating disorders

Eating disorders and their treatment present many ethical dilemmas. These are severe mental illnesses that have considerable consequences on all areas of sufferers' lives. Eating disorders are associated with reduced quality of life, high carer and societal burden and significant mortality. Whilst treatments evolve, it is widely acknowledged that our understanding of these conditions and effective treatment pathways is frustratingly inadequate. Eating disorders are philosophically perplexing in that they are experienced as part of the self and can become highly valued coping mechanisms. As a result, many patients will at some point deny aspects of their condition and avoid or refuse treatment. How should we approach challenging questions such as the following? Should treatment be enforced? Can a patient decide? Is coercion ever acceptable? Should patients be assisted in dying? An exploration of ethical principles can provide a framework, but the complexities of individual circumstances require a comprehensive, compassionate and flexible approach to these most fundamental issues. Ethical considerations must always be kept at the forefront of clinical decision-making.