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Why (and When) Clinicians Compel Treatment of Anorexia Nervosa Patients

European Eating Disorders Review, Vol. 16, No. 3, pp. 199-206, 2008

Sydney Law School Research Paper No. 08/103

18 Pages Posted: 15 Sep 2008  

Terry Carney

The University of Sydney Law School

David Tait

University of Canberra

Stephen Touyz

University of Sydney

Alice Richardson

University of Canberra

Date Written: September 14, 2008

Abstract

OBJECTIVE: This paper addresses the question of the circumstances which lead clinicians to use legal coercion in the management of patients with severe anorexia nervosa, and explores similarities and differences between such formal coercion and other forms of 'strong persuasion' in patient management. METHOD: Logistic regression and other statistical analysis was undertaken on 75 first admissions for anorexia nervosa from a sample of 117 successive admissions to an eating disorder facility in New South Wales, Australia, where an eating disorder was the primary diagnosis. Admissions with other primary diagnoses, such as bulimia nervosa (25 episodes), and entries with a co morbid diagnosis (e.g. depression or opiate overdose), were discarded, leaving 96 admissions by 75 individuals. RESULTS: Resort to measures of legal coercion into treatment was found to be associated with three main indicators: the patient's past history (number of previous admissions); the complexity of their condition (the number of other psychiatric co morbidities); and their current health risk (measured either by Body Mass Index or the risk of re-feeding syndrome). CONCLUSIONS: Our study is consistent with the few earlier studies about indicators for legal coercion in anorexia nervosa management, and suggests that clinicians use legal coercion very sparingly, distinguishing legal coercion from other forms of close clinical management of patients.

Keywords: anorexia nervosa, legal and extra legal coercion, clinical indications, empirical evidence

JEL Classification: C80, I10, I18, K10, K30

Suggested Citation

Carney, Terry and Tait, David and Touyz, Stephen and Richardson, Alice, Why (and When) Clinicians Compel Treatment of Anorexia Nervosa Patients (September 14, 2008). European Eating Disorders Review, Vol. 16, No. 3, pp. 199-206, 2008; Sydney Law School Research Paper No. 08/103. Available at SSRN: https://ssrn.com/abstract=1268063

Terry Carney (Contact Author)

The University of Sydney Law School ( email )

New Law Building, F10
The University of Sydney
Sydney, NSW 2006
Australia

David Tait

University of Canberra ( email )

Law Faculty
Canberra, ACT 2601
Australia

Stephen Touyz

University of Sydney ( email )

University of Sydney
Sydney NSW 2006, NC
Australia

Alice Richardson

University of Canberra ( email )

Canberra, Australian Capital Territory 2601
Australia

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