Treatment of anorexia nervosa in Ireland: striking an ethical balance

2026/02/02 by Eimear Dunne, Art Malone, Hakan Öğütlü +1
Medicine · Psychology · #Body Image and Dysmorphia Studies #Child Nutrition and Feeding Issues #Eating Disorders and Behaviors

paper · pdf · doi:10.1017/ipm.2026.10178

openalex publication_date 2026/02/02 · openalex created_date 2026/02/03 · openalex updated_date 2026/05/21

Abstract

Anorexia nervosa (AN) is a complex psychiatric illness with severe and life-threatening medical sequelae, including death. Existing evidence-based treatments are linked to good prognosis and full recovery in many. For a small minority of critically ill patients, treatment decisions extend beyond voluntary engagement. Severe cases may involve involuntary hospitalisation, nasogastric feeding, physical restraint, and other coercive measures. While these interventions are sometimes necessary to prevent death, they raise profound ethical concerns. This article explores the ethical tensions in treatment of individuals with AN through the lens of the four principles of biomedical ethics, respect for autonomy, beneficence, non-maleficence, and justice, examining the implications for clinical practice. It also outlines the legal mechanisms in Ireland governing involuntary treatment for AN. It considers treatment principles in children and adolescents as well as adults.

Citations

• Mortality Rates in Patients With Anorexia Nervosa and Other Eating Disorders
• Anorexia nervosa and personal identity: The accounts of patients and their parents
• Eating disorder outcomes: findings from a rapid review of over a decade of research
• “Terminal Anorexia”, Treatment Refusal and Decision-Making Capacity

Related

• Summary Australian and New Zealand Clinical Practice Guideline for the Management of Anorexia Nervosa(2003)
• Toward dignity-centred ethics in the treatment of longstanding and severe eating disorders: a lived experience-led narrative review
• Challenges in decision-making capacity in the acute hospital setting: two years on from the implementation of the Assisted Decision-Making (Capacity) Act 2015
• Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders
• “Terminal Anorexia”, Treatment Refusal and Decision-Making Capacity