Ethical dilemma Anorexia

[28871]

When caring for a patient with anorexia, how do we nurses decide when to follow the Dr's orders and administer tube feedings, or follow patient's wishes to let them decided to eat or not?

[nurseprnRN, BSN, RN]

Often people who have been hospitalized for anorexia are under some sort of guardianship or have signed some sort of behavior contract not to resist therapeutic interventions including tube feedings. Why do you ask?

[Meriwhen, ASN, BSN, MSN, RN]

Psychiatric patients--even involuntary ones--retain the right to refuse treatment...and yes, this would include tube feedings for the anorexic patient. The only way that right to refuse can be overturned and treatment forced on a patient is by a court-order or if the patient is a danger to themselves or others...but that danger refers to a patient who is about to physically harm themselves/someone else, and not someone refusing to eat.

However...if you have an anorexic patient who is NOT court-ordered to receive treatment but is still refusing to eat or have feedings, then you need to notify the MD of their refusal. The refusal to participate in their treatment needs to be addressed with the patient. Otherwise, why is the patient in the hospital if they don't want treatment?

[Esme12, ASN, BSN, RN]

Welcome to AN!

We are happy to help with home work but we won't do it for you........what do you think.....start the dialog and we will be happy to chime in!

[ChristineN, BSN, RN]

When caring for a patient with anorexia how do we nurses decide when to follow the Dr's orders and administer tube feedings, or follow patient's wishes to let them decided to eat or not?[/quote']

Generally there are clearly laid out. With the anorexic patients I have taken care of, they are supposed to eat so much a percentage of their meal. If they refuse to eat, or do not eat enough food, then they will get bolused with tube feeds down the NG tube. The patient is always given the option of eating first, before we resort in tube feeds