Involuntary Treatment and Quality of Life Terry Carney, PhD(Mon), LLB (Hons), Dip Crim(Melb) a, *, Joel Yager, MD b , Sarah Maguire, MA, DCP, PhD c , Stephen William Touyz, BSc (Cape Town), PhD (Cape Town) d INTRODUCTION Involuntary treatment of anorexia nervosa (AN) poses many clinical, medicolegal, hu- man rights, and ethical issues, as well as personal and familial challenges for the indi- vidual requiring care. From the perspective of care providers, the clinical challenge is in determining the circumstances warranting an intervention that is not requested by their client, may jeopardize the therapeutic relationship, and can potentially cause great distress for the client and carers, for a condition arguably carrying the highest psychiatric mortality rates. This is further complicated by the need to weigh evidence of the efficacy of competing treatments. The medicolegal challenge is navigating the complex conditions for invoking compulsory treatment authority and choosing be- tween any alternative routes provided. The human rights challenge is that the Conven- tion on the Rights of Persons with Disabilities is interpreted by its monitoring committee as ruling out retention or use of laws that override or displace a person’s a School of Law, The University of Sydney, New Law School Building, Eastern Avenue, New South Wales 2006, Australia; b Department of Psychiatry, University of Colorado School of Medicine, 13001 East 17th Place (Fitzsimons Building), MC A011-04, Aurora, CO 80045, USA; c InsideOut Institute, Charles Perkins Centre, University of Sydney, D17, New South Wales 2006, Australia; d School of Psychology and Inside Out Institute, University of Sydney, Brain Mind Centre, Room 321, 94 Mallett Street, Camperdown, New South Wales 2050, Australia * Corresponding author. E-mail address: Terry.carney@sydney.edu.au KEYWORDS  Anorexia nervosa  Involuntary treatment  Quality of life  Human rights KEY POINTS  Involuntary treatment is indicated for only a small proportion of persons experiencing life- threatening, unresponsive anorexia nervosa.  Involuntary treatment may be contraindicated or futile for some persons with severe and enduring anorexia nervosa.  Anorexia nervosa can have a profound effect across many domains of life.  Patients with severe and enduring anorexia nervosa have impairments in quality of life equal to those with depression or schizophrenia. Psychiatr Clin N Am 42 (2019) 299–307 https://doi.org/10.1016/j.psc.2019.01.011 psych.theclinics.com 0193-953X/19/ª 2019 Elsevier Inc. All rights reserved.