The refusal of treatment in anorexia nervosa, an ethical conflict with three characters: "the girl, the family and the medical profession". Discussion in a French legislative context.
Anorexic patients are prone to refuse treatment despite life-threatening complications. The therapist's ethical code can be torn between duty to protect life, and law that demands respect of the patient's autonomy. The age of these girls introduces a third participant in this ethical conflict with three characters: "the girl, her family and the physician". Even if her decision to refuse treatment can appear unreasonable, the patient suffering from anorexia nervosa remains "competent" to receive information concerning her state of health and to make up her own mind about what to do next. French law only recognises for the therapist a real duty to make efforts to convince the patient of the absolute necessity of treatment. However it appears important to confront these legal obligations with different situations created by the disease in order to help pave the way to finding medical solutions capable of conciliating the objective of the best treatment, the own ethical code of the physician and the respect of current legislation.
Vialettes
B
B
Service de Nutrition, Maladies métaboliques, Endocrinologie, France. bernard.vialettes@ap-hm.fr
Samuelian-Massat
C
C
Valéro
R
R
Béliard
S
S
D000856:Anorexia Nervosa / Q000523:psychology*; D003220:Conflict, Psychological; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D026684:Personal Autonomy; D012307:Risk Factors; D016312:Treatment Refusal