Coercion is Coercion?: Reflections on Clinical Trends in Use of Compulsion in Treatment of Anorexia Nervosa Patients
Australasian Psychiatry, Vol. 15, No. 5, pp. 390-395, 2007
13 Pages Posted: 3 Jan 2008
OBJECTIVE: This paper explores similarities and differences between formal coercion and other forms of 'strong persuasion' in clinical decision-making about medical management of patients with severe anorexia nervosa. METHOD: The paper builds on findings from analysis of data from 117 successive admissions to an eating disorder facility, where an eating disorder was the primary diagnosis. RESULTS: The study implications of particular interest in this paper are the findings that legal coercion into treatment was 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: We conclude that clinicians use legal coercion very sparingly in treating severe anorexia nervosa, distinguishing legal coercion from other forms of close clinical management of patients. While we agree with Monahan et al and others, that there are similarities between legal coercion and other forms of strong clinical management (or power), our results suggest that NSW clinicians recognise the importance of maintaining, rather than blurring that distinction.
Keywords: Anorexia Nervosa, Legal and Clinical Coercion, Clinical Management
JEL Classification: K10, K32, I10
Suggested Citation: Suggested Citation