At what point does an extreme mental health disorder become untreatable? And must doctors continue to treat those patients, even against their will? Katie Engelhart examines these questions in an in-depth look at how some psychologists are turning to palliative care for anorexia patients who are done fighting their conditions, while other doctors find the approach professionally unethical. (Palliative care, which began with dying cancer patients, focuses on relieving suffering rather than treating the ailment.) And while you’re sifting through the arguments for and against palliative psychology in the New York Times Magazine piece, you may find yourself flipping between both sides. The story begins with a patient named Naomi, whose anorexia—paired with bipolar disorder and severe depression—upended her life for years, often landing her in treatment programs without her consent.
After reading research that posited disordered eating patients should have a choice in discontinuing treatment, she learned one of its authors, Dr. Joel Yager, was local, and became his patient. Yager, who is central to the article, would go on to co-author a paper coining the term “terminal anorexia” in 2022, sparking debate over whether medical futility exists in mental health care. Detractors argue that without clear distinctions, there is no way to know if a patient is untreatable—one doctor who treated thousands of patients said they still “surprised” her, and she could never predict who would recover. Others voiced concern that terminal status could become a diagnosis patients strived to obtain. Now the debate is in full academic swing, and you can read it in fascinating detail here. (Or check out other Longform recaps.)
