Jonathan Treem, MD, Joel Yager, MD, and Jennifer L. Gaudiani, MD, CEDS-S
Some individuals with severe and enduring anorexia nervosa experience dramatically degraded quality of life in the face of refractory illness and compulsory treatment.
AMA J Ethics. 2023;25(9):E703-709. doi:
10.1001/amajethics.2023.703.
Treatment decisions in high-risk situations require a dynamic relationship between doctor and patient in which patient preferences and clinician recommendations contribute equally in shaping a final treatment decision.
My most important job is to help my patients (and their families) who are depressed, grieving, or angry following severe injury or illness to imagine possible narratives for the next chapter of life.
AMA J Ethics. 2015;17(6):500-505. doi:
10.1001/journalofethics.2015.17.6.ecas1-1506.
Dr Jonathan Treem joins Ethics Talk to discuss his article, coauthored with Drs Joel Yager and Jennifer L. Gaudiani: “A Life-Affirming Palliative Care Model for Severe and Enduring Anorexia Nervosa.”
The physician must help patients understand that all options—further testing, surgery, no action—carry risks and benefits. Disclosing the statistical probability of injury and other possible outcomes might help, but it can also hinder the process.
After assessing the reasons for a patient’s unrealistic hopefulness in the face of clear understanding, a clinician may believe that significant harm will come to the patient if he or she does not acknowledge the seriousness of the illness.