End-of-life care in a case of severe anorexia nervosa and end-stage liver disease

Martin Curtice, Wasan Bajallan, Caroline Winkle

  • Abstract

    This article reviews a Court of Protection case involving a woman, Ms X, with two severe medical conditions: anorexia nervosa and end-stage liver cirrhosis due to alcohol dependence. Each of these conditions alone warranted end-of-life care planning. When combined, they provided a far more unique and complex presentation because of the way they were intertwined. Ms X's life was in imminent danger. The Court implemented methodically the principles of the Mental Capacity Act 2005. Ms X was assessed as lacking capacity to make decisions in relation to treatment for her anorexia. However, she retained capacity to make decisions regarding treatment for her liver disease and the continued harmful use of alcohol. The Court ruled that it was not in Ms X's best interests to be subject to further compulsory treatment for her anorexia, even though this may have prolonged her life. It was also in her best interests and lawful not to provide nutrition and hydration with which she did not comply.

  • Contributors

    Martin Curtice, Wasan Bajallan, Caroline Winkle


    Correct at article publish date

    1 Consultant in Old Age Psychiatry, Worcestershire Health and Care NHS Trust, New Haven, Princess of Wales Community Hospital, Bromsgrove, Worcestershire, UK
    2 ST5 in Old Age Psychiatry, Princess of Wales Community Hospital, Bromsgrove, Worcestershire, UK
    3 ST6 in Old Age Psychiatry, Coventry and Warwickshire Partnership Trust, Caludon Centre, Coventry, UK
    4 Dudley and Walsall Mental Health Partnership NHS Trust, Bloxwich Hospital, Walsall, UK

    Author notes

    Correspondence to Dr Martin Curtice, martincurtice@nhs.net

    Original publishing information

    • Publisher: St Christopher's Hospice
    • Publish date: 01/01/2016
    • ePub Date: 20/01/2016
    • Volume: 6
    • Issue: 1

    Permissions: Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/2016

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