2026 Volume 14 Pages 52-61
The most severe and chronic forms of anorexia nervosa (AN) are classified as severe and enduring anorexia nervosa (SEAN). Due to extreme physical deterioration, SEAN patients may sometimes require emergency transport and involuntary treatment, raising significant legal and ethical challenges. This study analyzes the ethical dilemmas faced by nurses in two SEAN cases with divergent outcomes, where survival was uncertain, through the framework of ethical principles. As a result, three primary themes were identified : (1) conflicts between life-saving treatment and palliative care, (2) conflicts arising from inadequate treatment due to patient and family non-consent, and (3) conflicts related to treatment resistance and healthcare system challenges. These dilemmas were attributed to uncertain evidence of treatment for SEAN, conflicting values, and systemic inadequacies. This study suggests that nurses, through critical reflection and ethical deliberation, may play a key role in mediating value conflicts among patients, families, and healthcare professionals, thereby encouraging collaborative decision-making.
