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A MULTI-PROFESSIONAL DILEMMA

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A MULTI-PROFESSIONAL DILEMMA

Anne, who comes from a small rural community, is a 19-year-old second year university student living at a large urban University. A high academic achiever, at 14 she turned down an opportunity to board at a prestigious private girls’ school in the city in order to be closer to her family.

Anne adores her mother, and envies her pretty and petite physique. Though her sister is thin like her mother, Anne has inherited her father‘s larger framed body type.

When she started University Anne began exercising regularly, eating salads and fruit only and avoiding energy-dense foods. She joined the gym and became increasingly intent on exercise - working out sometimes 3 - 4 hours a day. She much preferred exercise to studying and her academic interest and work fell away.

Anne recently became very upset because she injured her lower back, making most forms of exercise impossible. She consulted her GP who, on seeing her physical appearance and listening to her, took several tests. She was found to weigh 40 kilos and her BMI result was:

BMI = 13.84 kg/m2. This result suggests anorexia nervosa.

Normal BMI range is : 18.5 - 25 kg/m2

The tests by her physician showed that her serum potassium is dangerously low and that she has an abnormal ECG characterised by a prolonged QT interval. This could prove fatal, especially if she returns to heavy exercise.

Her doctor explained the situation calmly and carefully and suggested she seeks help in hospital. Anne refused.

At this her doctor restated the fact that this is a life-threatening condition and told Anne that he considers her to be a danger to herself and arranged for her to be admitted to hospital involuntarily, under powers available in the Mental Health Act.

She is now in hospital against her will and is refusing all food. You are a member of the care team.

What do you do?

Please respond to the survey and then carefully read other people's views.

NOTE: 

In cardiology, the QT interval is a measure of the time between the start of the Q wave and the end of the T wave in the heart's electrical cycle. The QT interval represents electrical depolarization and repolarization of the ventricles.

ECG (electrocardiogram) is a test that measures the electrical activity of the heart. The heart is a muscular organ that beats in rhythm to pump the blood through the body. The signals that make the heart's muscle fibres contract come from the sinoatrial node, which is the natural pacemaker of the heart.

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women.