- Title Pages
- Series Foreword
- Foreword
- Acknowledgments
- I Foundational Questions
- 1 Contested Boundaries: Psychiatry, Disease, and Diagnosis
- 2 Moot Questions in Psychiatric Ethics
- 3 The Ethics of Psychotherapy
- 4 Character Virtues in Psychiatric Practice
- II Capacity, Coercion, and Consent
- 5 Psychiatric Advance Directives and the Treatment of Committed Patients
- 6 Denying Autonomy in Order to Create It: The Paradox of Forcing Treatment upon Addicts
- 7 End-Stage Anorexia: Criteria for Competence to Refuse Treatment
- 8 “Personality Disorder” and Capacity to Make Treatment Decisions
- III Violence, Trauma, and Treatment
- 9 Sanctity of Human Life in War: Ethics and Post-traumatic Stress Disorder
- 10 The Experience of Violent Injury for Young African American Men: The Meaning of Being a “Sucker”
- 11 The Psychological Impact of Rape Victims’ Experiences with the Legal, Medical, and Mental Health Systems
- IV Addiction
- 12 Addiction as Accomplishment: The Discursive Construction of Disease
- 13 The Ethics of Addiction
- 14 Myths about the Treatment of Addiction
- 15 Ethical Considerations in Caring for People Living with Addictions
- V Mental Illness and the Courts
- 16 Confidentiality and the Prediction of Dangerousness in Psychiatry
- 17 Madness versus Badness: The Ethical Tension between the Recovery Movement and Forensic Psychiatry
- 18 Ethical Considerations of Multiple Roles in Forensic Services
- 19 Watch Your Language: A Review of the Use of Stigmatizing Language by Canadian Judges
- VI Therapeutic Boundaries
- 20 Boundary Violation Ethics: Some Conceptual Clarifications
- 21 The Price of a Gift: An Approach to Receiving Gifts from Patients in Psychiatric Practice
- 22 How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness
- 23 Boundary Issues in Social Work: Managing Dual Relationships
- 24 Patient-Targeted Googling: The Ethics of Searching Online for Patient Information
- 25 Professional Boundaries in the Era of the Internet
- Contributors
- Permissions and Credits
- Index
End-Stage Anorexia: Criteria for Competence to Refuse Treatment
End-Stage Anorexia: Criteria for Competence to Refuse Treatment
- Chapter:
- (p.91) 7 End-Stage Anorexia: Criteria for Competence to Refuse Treatment
- Source:
- Applied Ethics in Mental Health Care
- Author(s):
Margery Gans
Willam B. Gunn Jr.
- Publisher:
- The MIT Press
In this paper, the authors introduce a case in which the central question was the competence of a woman in the end stages of anorexia nervosa to refuse treatment when she knew that death was a likely outcome. Then, the authors identify the major issues relevant in this situation: the nature of anorexia nervosa, the notion of competence, and the complications inherent in determining competence to refuse life-saving treatment in a patient diagnosed with anorexia nervosa. Finally, the authors identify the criteria we used to determine competence in this patient and describe the process we used to assess her competence.
Keywords: Anorexia, Autonomy, Competence, Capacity, Ethics, Futility, Psychiatry
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- Title Pages
- Series Foreword
- Foreword
- Acknowledgments
- I Foundational Questions
- 1 Contested Boundaries: Psychiatry, Disease, and Diagnosis
- 2 Moot Questions in Psychiatric Ethics
- 3 The Ethics of Psychotherapy
- 4 Character Virtues in Psychiatric Practice
- II Capacity, Coercion, and Consent
- 5 Psychiatric Advance Directives and the Treatment of Committed Patients
- 6 Denying Autonomy in Order to Create It: The Paradox of Forcing Treatment upon Addicts
- 7 End-Stage Anorexia: Criteria for Competence to Refuse Treatment
- 8 “Personality Disorder” and Capacity to Make Treatment Decisions
- III Violence, Trauma, and Treatment
- 9 Sanctity of Human Life in War: Ethics and Post-traumatic Stress Disorder
- 10 The Experience of Violent Injury for Young African American Men: The Meaning of Being a “Sucker”
- 11 The Psychological Impact of Rape Victims’ Experiences with the Legal, Medical, and Mental Health Systems
- IV Addiction
- 12 Addiction as Accomplishment: The Discursive Construction of Disease
- 13 The Ethics of Addiction
- 14 Myths about the Treatment of Addiction
- 15 Ethical Considerations in Caring for People Living with Addictions
- V Mental Illness and the Courts
- 16 Confidentiality and the Prediction of Dangerousness in Psychiatry
- 17 Madness versus Badness: The Ethical Tension between the Recovery Movement and Forensic Psychiatry
- 18 Ethical Considerations of Multiple Roles in Forensic Services
- 19 Watch Your Language: A Review of the Use of Stigmatizing Language by Canadian Judges
- VI Therapeutic Boundaries
- 20 Boundary Violation Ethics: Some Conceptual Clarifications
- 21 The Price of a Gift: An Approach to Receiving Gifts from Patients in Psychiatric Practice
- 22 How Certain Boundaries and Ethics Diminish Therapeutic Effectiveness
- 23 Boundary Issues in Social Work: Managing Dual Relationships
- 24 Patient-Targeted Googling: The Ethics of Searching Online for Patient Information
- 25 Professional Boundaries in the Era of the Internet
- Contributors
- Permissions and Credits
- Index
