First, do no harm: the proposed definition of "terminal anorexia" is fraught with danger for vulnerable individuals

Megan Riddle; Anne Marie O'Melia; Maryrose Bauschka

doi:10.1186/s40337-022-00605-x

First, do no harm: the proposed definition of "terminal anorexia" is fraught with danger for vulnerable individuals

J Eat Disord. 2022 Jun 16;10(1):81. doi: 10.1186/s40337-022-00605-x.

Authors

Megan Riddle¹, Anne Marie O'Melia², Maryrose Bauschka^{3

4}

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, 98195, USA.
² Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA.
³ Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, 84108, USA. maryrose.bauschka@ucdenver.edu.
⁴ Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA. maryrose.bauschka@ucdenver.edu.

Abstract

A recent article in the Journal of Eating Disorders (10:23, 2022) proposed criteria for "terminal anorexia" with a cited goal of improving access to end-of-life care (Gaudiani et al. in J Eat Disord 10(1):23, 2022). The authors presented three cases in which patients received end-of-life care, including the prescription of medical assistance in dying (MAID), also known as physician-assisted suicide (PAS). The proposed criteria lack the evidence base for adoption and do not acknowledge the compelling evidence that exists surrounding possible prolonged timelines to recovery for some individuals and the nuances of assessing capacity in this population.

Keywords: Anorexia nervosa; Capacity; Medical assistance in dying; Physician-assisted suicide; Severe and enduring anorexia nervosa; Severe and enduring eating disorders; Terminal anorexia.

Publication types

Letter