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Minerva Psichiatrica 2008 June;49(2):157-73

language: Italian

Ethical problems in the treatment of anorexia nervosa: an international literature’s review

Fassino S., Abbate Daga G., Leombruni P., Delsedime N.

SCDU Psichiatria Centro Pilota Regionale per i DCA Azienda Ospedaliera-Universitaria S. Giovanni Battista, Torino Università di Torino, Torino, Italia


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The aim of this paper was to make a critical review of the studies in the medical literature in the last 30 years about the problems that can emerge in the treatment of anorexia nervosa (AN) as the resistance to treatment, the drop-out, the importance of therapeutic alliance – and the border between therapeutic fury and compulsory treatment; in conclusion some critical reflections are presented. The studies and papers taken in consideration can be grouped areas according to their subjects: the will in patients with AN; the evaluation of their competence; the distinction between refusal and resistance to treatment and drop-out from therapy; AN as chronic disease; the counter-transference of the therapist; the terminal AN; the palliative cares; the legal situation in Italy. The attempt of this paper is to define limits and duties regarding the treatment of AN, a disease that compromises both the body and the mind of the patients and this is related to the base of resistance to treatment. There are, however, few answers for the therapist that in the daily work confront clinical problems with also an ethical value.

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