LOGO
EN

The opinion of experts with respect to dealing with patients suffering from severe anorexia nervosa who do not consent to treatment

Barbara Remberk1, Agnieszka Gmitrowicz2, Małgorzata Janas-Kozik3, Irena Namysłowska4, Tomasz Wolańczyk5, Andrzej Rajewski6, Agnieszka Słopień7, Piotr Gorczyca8, Anita Bryńska5, Izabela Łucka9, Ireneusz Jelonek3, Piotr Sierakowski10
Affiliacja i adres do korespondencji
Psychiatr Psychol Klin 2018, 18 (3), p. 229–233
DOI: 10.15557/PiPK.2018.0028
PlumX metrics:
Streszczenie

Anorexia nervosa is a disorder which, in the absence of treatment or in an unfavourable course, can lead to the death of the patient. Frequently, reduced criticism is the element of the psychopathological picture which can result in lack of consent to the proposed treatment. The Mental Health Act specifies the situations in which the treatment without the person’s consent is acceptable. A meeting of the team of experts appointed by the National Consultant in the field of Child and Adolescent Psychiatry was devoted to this issue. In the course of the discussion, the following opinion was formulated: there is a group of patients whose symptoms of anorexia nervosa meet the criteria for thought and perceptual disorders corresponding to the concept of mental illness within the meaning of article 23 and 29 of the Mental Health Act, while their physical condition and persistence in pursuing life-threatening behaviours pose danger to life. The symptoms meeting the criteria for thought and perceptual disorders corresponding to the concept of mental illness most often concern the assessment of reality (cause-and-effect relationships, assessment of one’s own health condition, perception of one’s own body). These beliefs are pathological in nature and are patently false (such as the conviction of one’s own obesity in an extremely emaciated person), despite being experienced as obvious. They are not subject to reflection or correction in the course of discussion, even in the face of clear evidence of exceedingly poor physical condition provided by additional tests. The character and severity of the symptoms correspond in such situations to the thought and perceptual disorders present in psychosis. There is, therefore, a group of patients with anorexia nervosa in whose case the disease can be considered a mental disorder within the meaning of the Mental Health Act and with respect to whom the fulfilment of the requirements stated in Art 23 or 29 of the Act can be established.

Słowa kluczowe
anorexia nervosa, consent to treatment, treatment against the person’s will, mental illness