Eating disorders (and especially anorexia nervosa) are associated with severe disability, poor quality of life and high mortality rate. Anorexia nervosa ranks among the main causes of death among young women. Despite physical and psycho-social impairment, patients suffering from anorexia nervosa do not recognize low body weight and extreme calorie restriction as a clinical problem and are ambivalent towards treatment. Some patients with anorexia nervosa refuse treatments though presenting severe medical complications and having a high mortality risk. Hence the need to evaluate when it could be appropriate to prescribe a compulsory treatment in the more complex cases who refuse interventions, deemed necessary for them. To date, the compulsory treatment in anorexia nervosa is still under debate: some authors take into account the negative impact on the therapeutic relationship, other authors consider it as a compassionate treatment or as life-saving therapy. Indeed, compulsory treatment for eating disorders must always be weighed very carefully because it is considered by law as the highest form of restriction of personal freedom. Political Institutions must provide a clear framework for the society and for professionals, while the health care services must face the problem of the adequacy of available resources (not only in terms of hospital beds but also of skilled professionals) compared to patients' needs, considering the organization and the integration of clinical services dedicated to the treatment of eating disorders.

[Seeking compulsory treatment as life-saving in the presence of eating disorders: a complex choice] / Milano, Walter; Cotugno, Armando; Dalle Grave, Riccardo; Gentile, Maria Gabriella; Gravina, Giovanni; Renna, Caterina; Salvo, Pierandrea; Todisco, Patrizia; Donini, Lorenzo Maria. - In: RIVISTA DI PSICHIATRIA. - ISSN 2038-2502. - 52:5(2017), p. 180-188. [10.1708/2801.28345]

[Seeking compulsory treatment as life-saving in the presence of eating disorders: a complex choice]

Donini, Lorenzo Maria
2017

Abstract

Eating disorders (and especially anorexia nervosa) are associated with severe disability, poor quality of life and high mortality rate. Anorexia nervosa ranks among the main causes of death among young women. Despite physical and psycho-social impairment, patients suffering from anorexia nervosa do not recognize low body weight and extreme calorie restriction as a clinical problem and are ambivalent towards treatment. Some patients with anorexia nervosa refuse treatments though presenting severe medical complications and having a high mortality risk. Hence the need to evaluate when it could be appropriate to prescribe a compulsory treatment in the more complex cases who refuse interventions, deemed necessary for them. To date, the compulsory treatment in anorexia nervosa is still under debate: some authors take into account the negative impact on the therapeutic relationship, other authors consider it as a compassionate treatment or as life-saving therapy. Indeed, compulsory treatment for eating disorders must always be weighed very carefully because it is considered by law as the highest form of restriction of personal freedom. Political Institutions must provide a clear framework for the society and for professionals, while the health care services must face the problem of the adequacy of available resources (not only in terms of hospital beds but also of skilled professionals) compared to patients' needs, considering the organization and the integration of clinical services dedicated to the treatment of eating disorders.
2017
Adolescent; Anorexia Nervosa; Bioethical Issues; Child; Emergencies; Europe; Feeding and Eating Disorders; Female; Humans; Informed Consent; Italy; Living Wills; Male; Mental Competency; Minors; Patient Acceptance of Health Care; Personal Autonomy; Commitment of Mentally Ill; Enteral Nutrition
01 Pubblicazione su rivista::01a Articolo in rivista
[Seeking compulsory treatment as life-saving in the presence of eating disorders: a complex choice] / Milano, Walter; Cotugno, Armando; Dalle Grave, Riccardo; Gentile, Maria Gabriella; Gravina, Giovanni; Renna, Caterina; Salvo, Pierandrea; Todisco, Patrizia; Donini, Lorenzo Maria. - In: RIVISTA DI PSICHIATRIA. - ISSN 2038-2502. - 52:5(2017), p. 180-188. [10.1708/2801.28345]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1134685
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