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The Counseling Psychologist
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Conference

When Does the "Duty to Protect" Apply with a Client Who has Anorexia Nervosa?

James L. Werth, Jr.

University of Akron jwerth{at}uakron.edu

Kimberly S. Wright

Arizona State University

Rita J. Archambault

Arizona State University

Rebekah J. Bardash

University of Akron

Individuals with eating disorders, especially those with anorexia nervosa, have the potential to experience significant harm and even death as a result of behaviors related to their condition. Because of this risk, the authors argue that there is a duty to protect (i.e., an obligation to take some action when a person is engaging or considering engaging in a behavior that may lead to self-harm) when a client's anorexia-related behavior has progressed to the point of medical jeopardy—that is, her or his life is in danger. This article reviews information on anorexia, including mortality data; ethical and legal issues when a client is believed to be a harm-to-self; and the literature related to involuntary hospitalization and compulsory treatment of clients with anorexia. The article concludes with a set of guidelines for when the duty to protect when a client has anorexia nervosa begins and with suggestions for interventions.

The Counseling Psychologist, Vol. 31, No. 4, 427-450 (2003)
DOI: 10.1177/0011000003031004006
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