Tipping the scales: ethical and legal dilemmas in managing severe eating disorders
Gibson, D. & Mehler, PS (2021). Role of medical guardianship. In Westmoreland, P. (Ed.) Tipping the scales: ethical and legal dilemmas in managing severe eating disorders. American Psychiatric Association Publishing.
Tipping the Scales: Ethical and Legal Dilemmas in Managing Severe Eating Disorders centers on the complex and at times wrenching medicolegal and ethical challenges encountered in treating patients with severe and enduring eating disorders (SEEDs). Unlike other mental health disorders, for which the care of a medical physician is typically unnecessary, patients with eating disorders have many significant medical complications that demand careful oversight by a physician knowledgeable in treating these disorders. The tragic dearth of such expertise is made more alarming by the fact that anorexia nervosa has the highest mortality rate of any mental disorder aside from opioid abuse. Accordingly, the book addresses the medical consequences of SEEDs and explores that subgroup of patients whose illness appears intractable—people who are no longer seeking a “cure” but, rather, enough improvement to afford them a reasonable quality of life. For such patients, depending on their age, treatment history, and support system, treatment teams may either commit to achieving a full recovery or engage in a harm reduction model.