Graphic Pathographies as Ethical Texts: Autonomy and Agency in Narratives of Anorexia Nervosa

Anorexia nervosa presents profound challenges to both patients and healthcare providers, as treatment often conflicts with the individual's values, voice, and sense of control. Traditional clinical approaches tend to prioritize medical outcomes over patient autonomy, frequently resulting in coercive interventions grounded in assumptions about impaired decision-making capacity. This paper examines how graphic pathographies, personal, visual narratives created by those living with illness, offer a compelling alternative lens on autonomy in anorexia nervosa by centering lived experience and moral agency. Using a narrative ethics framework, Nervosa (Gold 2023) is analyzed for its depiction of the complex, shifting ways individuals with anorexia understand and assert agency within the constraints of their condition. This multimodal text challenges dominant biomedical narratives that marginalize patient perspectives, instead revealing how autonomy is negotiated, reimagined, and ethically expressed through art and storytelling. By foregrounding the patient's voice, Nervosa brings into focus dimensions of care, relationality, and moral complexity that are often overlooked in clinical settings. The findings suggest that graphic pathographies can serve not only as testimonies of suffering but as ethical texts that expand how we understand autonomy, less as an isolated capacity and more as a dynamic, context-dependent process. Integrating graphic medicine into ethical and clinical conversations about anorexia holds the potential to foster more empathetic, responsive, and relational forms of care.