Analyzing Legal and Ethical Rights of Patients with Anorexia Nervosa to Refuse Life-Saving Treatments Like PEG Feeding
Analyzing the legal and ethical rights of a 22-year-old patient with severe anorexia nervosa to refuse PEG tube insertion and artificial nutrition in contemporary medical practice. Sally is 22 years old and has a 6 year history of anorexia nervosa. This young adult’s case reflects the persistent challenges many face when eating disorders escalate despite years of management. In recent weeks, her condition has deteriorated to the point where her treating Medical Officer has prescribed the administration of artificial nutrition (in the form of PEG feeds). However, Sally is refusing to consent to both the insertion of a PEG tube and to artificial feeding. Advances in mental health legislation continue to influence how such refusals are handled in clinical settings today. Does Sally have a legal right to refuse these procedures?
Explain your position from both a legal and an ethical perspective. Courts increasingly consider capacity assessments in determining patient autonomy for these interventions.
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For instance, from a legal standpoint, if Sally demonstrates mental capacity under frameworks like the Mental Capacity Act, she may validly refuse treatment even if it risks her life. Ethically, this pits patient autonomy against the principle of beneficence, where healthcare providers aim to prevent harm through necessary nutrition. Recent guidelines emphasize collaborative decision-making to balance these tensions in anorexia cases.
Does a patient with anorexia nervosa have the right to refuse PEG tube and artificial feeding legally and ethically?
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Cave, E. and Tan, J. (2025) ‘Evolving judicial approaches to longstanding anorexia nervosa’, Medical Law International [Preprint]. doi:10.1177/14777509251391973. Available at: https://journals.sagepub.com/doi/10.1177/14777509251391973 (Accessed: 12 January 2026).
Rauch, S. et al. (2024) ‘Ethical concerns in caring for persons with anorexia nervosa: content analysis of a series of documentations from ethics consultations’, BMC Medical Ethics, 25(1). doi:10.1186/s12910-024-01101-4. Available at: https://link.springer.com/article/10.1186/s12910-024-01101-4 (Accessed: 12 January 2026).
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Yager, J. (2024) ‘“Terminal Anorexia”, Treatment Refusal and Decision-Making Capacity’, Cambridge Quarterly of Healthcare Ethics, 33(4), pp. 558–569. doi:10.1017/S0963180124000367. Available at: https://www.cambridge.org/core/journals/cambridge-quarterly-of-healthcare-ethics/article/terminal-anorexia-treatment-refusal-and-decisionmaking-capacity/7B2D699F99470A65E9265290704E1BA0 (Accessed: 12 January 2026).
Clausen, L. and Jones, A. (2020) ‘Perspectives on Involuntary Treatment of Anorexia Nervosa’, Frontiers in Psychiatry, 11. doi:10.3389/fpsyt.2020.533288. Available at: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2020.533288/full (Accessed: 12 January 2026).
