Abstract

Eating disorders are mental illnesses that can have a significant and persistent physical impact, especially for those who are not treated early in their disease trajectory. Although many persons with eating disorders may make a full recovery, some may not; this is especially the case when it comes to persons with severe and enduring anorexia nervosa (SEAN), namely, those who have had anorexia for between 6 and 12 years or more. Given that persons with SEAN are less likely to make a full recovery, a different treatment philosophy might be ethically warranted. One potential yet scarcely considered way to treat persons with SEAN is that of a harm reduction approach. A harm reduction philosophy is deemed widely defensible in certain contexts (e.g. in the substance use and addictions domain), and in this paper we argue that it may be similarly ethically defensible for treating persons with SEAN in some circumstances.

摘要

饮食失调是一种精神疾病，会对身体产生重大而持久的影响，特别是对于那些在疾病轨迹早期未得到治疗的人。虽然许多饮食失调的人可能会完全康复，但有些人可能不会；对于患有严重且持久的神经性厌食症 (SEAN) 的人，即患有厌食症 6 至 12 年或更长时间的人尤其如此。鉴于患有 SEAN 的人不太可能完全康复，因此在伦理上可能需要采用不同的治疗理念。一种潜在但很少考虑的治疗 SEAN 患者的方法是减少危害的方法。在某些情况下（例如在物质使用和成瘾领域），减少危害的理念被广泛认为是站得住脚的，