Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2006 Dec;13(4):267-282.
doi: 10.1353/ppp.2007.0032.

Competence to make treatment decisions in anorexia nervosa: thinking processes and values

Dr Jacinta O A Tan  1 , Professor Tony Hope, Dr Anne Stewart, Professor Raymond Fitzpatrick
Affiliations

Competence to make treatment decisions in anorexia nervosa: thinking processes and values

Dr Jacinta O A Tan et al. Philos Psychiatr Psychol. 2006 Dec.

Abstract

This paper explores the ethical and conceptual implications of the findings from an empirical study of decision-making capacity in anorexia nervosa. In the study, ten female patients aged 13 to 21 years with a diagnosis of anorexia nervosa, and eight sets of parents, took part in semi-structured interviews. The purpose of the interviews was to identify aspects of thinking that might be relevant to the issue of competence to refuse treatment. All the patient participants were also tested using the MacCAT-T test of competence. This is a formalised, structured interviewer-administered test of competence, which is a widely accepted clinical tool for determining capacity. The young women also completed five brief self-administered questionnaires to assess their levels of psychopathology.The issues identified from the interviews are described under two headings: difficulties with thought processing, and changes in values. The results suggest that competence to refuse treatment may be compromised in people with anorexia nervosa in ways that are not captured by traditional legal approaches or current standardised tests of competence.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Self-administered psychopathology questionnaire scores Note: The Rosenberg Self-Esteem Questionnaire has no normal limits, the higher the score the higher the self esteem to a maximum of 40 points
Figure 2
Figure 2
EDE-Q4 scores of patient participants Note: The EDE-Q4 is a questionnaire which measures eating disorder pathology in four different dimensions, each scored in the respective subscales
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fourth edition, text revision (dsm-iv-tr®) Arlington, VA, USA: American Psychiatric Publications, Inc; 2000. 307.1 anorexia nervosa.
    1. Appelbaum PS. Ought we to require emotional capacity as part of decisional competence? Kennedy Inst Ethics J. 1998;8(4):377–387. - PubMed
    1. Appelbaum PS, Rumpf T. Civil commitment of the anorexic patient. Gen Hosp Psychiatry. 1998;20(4):225–230. - PubMed
    1. Beck AT, Steer RA. San Antonio, Texas: Psychological Corporation; 1993a. Manual for the beck anxiety inventory.
    1. Beck AT, Steer RA. San Antonio, Texas: Psychological Corporation; 1993b. Manual for the revised beck depression inventory.

LinkOut - more resources