A severely emaciated 16-year-old girl with anorexia nervosa is brought to A&E by her parents. She is refusing to eat and refusing any medical intervention. How do you manage this?

Tips to guide your answer

- MARSIPAN (adults) and Junior MARSIPAN (under-18s) provide guidance on medical risk assessment in severe anorexia

- Key physical parameters: BMI, heart rate (bradycardia), blood pressure (hypotension), temperature (hypothermia), squat test (muscle weakness), blood glucose, electrolytes (especially phosphate, potassium, magnesium)

- BMI <13 in adults (or appropriate centile in young people) indicates high risk

- Refeeding syndrome: dangerous shifts in electrolytes (especially hypophosphataemia) when nutrition is restarted in severely malnourished patients; can cause cardiac arrhythmias and death

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How to approach this Psychiatry interview question

This ethics question is common in Psychiatry NHS interviews because it reveals how you think under interview pressure, not just what facts you can recall. Use "A severely emaciated 16-year-old girl with anorexia nervosa is brought to A&E by her..." as the anchor for a concise answer with a clear opening, a clinical or professional structure, and a reflective close.

What the panel is testing

A strong ethics answer makes the competing duties visible. Name the principle or legal issue, then describe the practical steps you would take in the hospital: gather facts, assess capacity where relevant, seek advice, document, and protect the patient. For psychiatry, risk assessment, capacity, legislation, rapport, and multidisciplinary planning are usually central. Keep the answer humane, structured, and legally aware.

Identify the ethical tension before jumping to a decision: capacity, consent, confidentiality, best interests, or law.
Use local policy and senior advice, and be explicit about safeguarding or immediate patient-safety concerns.
Balance respect for autonomy with professional duties, documentation, and clear communication.

How to structure your answer

For a ethics prompt, aim for a short opening sentence, then two or three evidence-led points, then a final reflection. If you use STAR, keep the result and reflection as strong as the situation. If it is a clinical scenario, say what you would do now, what you would do next, and how you would keep the patient safe while help is coming.

Open by naming the main issue in the question.
Give a structured response rather than a memorised script.
End with escalation, documentation, learning, or follow-up.

Common mistakes to avoid

The weakest answers usually stay too vague, ignore the specific role, or miss the safety issue hidden in the question. Do not use this page to memorise a perfect paragraph. Use it to rehearse the shape of a safe answer, then adapt it to your own experience and the post you are applying for.

MARSIPAN (adults) and Junior MARSIPAN (under-18s) provide guidance on medical risk assessment in severe anorexia
Key physical parameters: BMI, heart rate (bradycardia), blood pressure (hypotension), temperature (hypothermia), squat test (muscle weakness), blood glucose, electrolytes (especially phosphate, potassium, magnesium)
BMI <13 in adults (or appropriate centile in young people) indicates high risk