Finding the balance between respecting autonomy and life-saving anorexia nervosa care: an Australian perspective

Use of involuntary treatment or coercion in the treatment and management of eating disorders is controversial, whether from a clinical, legal or ethical standpoint. With particular reference to Victorian reforms to mental health and guardianship legislation, and selected developments elsewhere, this paper reviews the role of law in authorising the use, duration and oversight of use of coercion in the treatment of eating disorders. The paper finds that Victoria's legislative framework offers appropriate, if incomplete, high-level guidance on minimisation of coercion and avoidance of psychological harm and impairment of therapeutic relationships. The paper concludes that detailed clinical practice guidelines are required to be developed by bodies such as the Chief Psychiatrist in order to adequately accommodate the nuances and complexities of care and treatment of eating disorders.