Anorexia nervosa and respecting a refusal of life-prolonging therapy: A limited justification

People who suffer from eating disorders often have to be treated against th eir will, perhaps by being detained, perhaps by being forced to eat. In thi s paper it is argued that whilst forcing compliance is generally acceptable there may be circumstances under which a sufferer's refusal of consent to treatment should be respected This argument will hinge upon whether someone in the grip of an eating disorder can actually make competent decisions ab out their quality of life. If so, then the decision to refuse therapy may b e on a par with other decisions to refuse life-prolonging therapy made by s ufferers of debilitating chronic, or acute onset terminal illness. In such cases, palliation might justifiably replace aggressive therapy. The argumen t will also draw heavily on the distinction between competent refusal of th erapy and passive euthanasia, and the distinction between incompetent and i rrational decisions. Both distinctions will then be applied to decisions to refuse food. The extent to which sufferers from anorexia nervosa can be ca tegorised as either incompetent or irrational will be examined. Tt is again st this background that it will be argued that at least some of those who s uffer from eating disorders should have their refusals respected, even if t hey may die as a result.