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Understanding Eating DisordersConceptual and Ethical Issues in the Treatment of Anorexia and Bulimia Nervosa$
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Simona Giordano

Print publication date: 2005

Print ISBN-13: 9780199269747

Published to Oxford Scholarship Online: February 2006

DOI: 10.1093/0199269742.001.0001

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Anorexia Nervosa and Refusal of Life‐Saving Interventions

Anorexia Nervosa and Refusal of Life‐Saving Interventions

Chapter:
(p.235) 13 Anorexia Nervosa and Refusal of Life‐Saving Interventions
Source:
Understanding Eating Disorders
Author(s):

Simona Giordano (Contributor Webpage)

Publisher:
Oxford University Press
DOI:10.1093/0199269742.003.0014

This chapter considers the case in which the anorexic patient refuses naso-gastric feeding. It argues the principle of autonomy seems prima facie to dictate that the patient’s decision not to be fed should be respected, if the decision appears to be autonomous. However, this chapter shows that the principle of autonomy is not a sufficient ground for accepting the sufferer’s decision to die, in the case of anorexia nervosa. The decision to omit or withdraw life-saving treatment for anorexia necessarily has to rest on the capacity to identify with the suffering of the patient, and on the willingness to end the pains of the sufferer. In short, on one’s compassion. The death of the anorexic can be prevented and the effects of abnormal eating are completely reversible. The refusal of artificial feeding and hydration may therefore be profoundly devastating for carers, possibly more devastating than the refusal of therapy in cases of untreatable degenerative or mortal illnesses. This is humanly understandable and ethically relevant, and seems to weaken the normative strength of the principle of respect for people’s competent decisions.

Keywords:   competence, refusal, naso-gastric feeding, euthanasia, food withdrawal, compassion

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