Humbling for doctors

“None of these cases, however exhausted, are really hopeless as long as life exists,” commented William Gull about anorexia nervosa in 1873.1 Doctors have up to now been exhorted never to give up in the attempt to induce anorectic patients to eat and restore weight even if, as Gull also said, this might entail the need to “fight for every mouthful.” Two personal views in this week's journal2 3 and a recent paper on treating anorexia nervosa as a terminal disease4 raise disturbing questions for those who battle with this common and tragic illness.

Treatment of patients with anorexia nervosa must be constantly reviewed to ascertain that it accords with the five ethical principles of beneficence, autonomy, non-maleficence, justice, and utility. All …