CIVIL COMMITMENT OF THE ANOREXIC PATIENT

Involuntary commitment appears to be an infrequently used intervention with anorexic patients, ill part because of clinicians' uncertainly a bout its applicability to this population. In contrast to overtly suic idal patients, anorexic patients typically fail to express an intent t o harm themselves, although their actions may result in severe harm. E xamination of the language of civil commitment statutes, however, sugg ests that when the behavior of anorexic patients endangers their lives , they will usually be committable under grave disability standards. T his appears to comport with the practices of experts in the treatment of anorexia, and with practices in other countries as well. Involuntar y commitment should be used as an approach gf last resort, when patien ts decline voluntary hospitalization and their physical safety is at r isk.,Moreover, civil commitment should probability also be limited to circumstances in which therapeutic gain is likely from hospitalization . Many severely ill anorexic patients will lack competence to make tre atment decisions on their own behalf allowing involuntary feeding and other procedures to rake place, if necessary. Civil commitment is a to ol that can legitimately be used in emergent situations with anorexic patients. (C) 1998 Elsevier Science Inc.