A letter from the patient convinced him she fully understood what she wanted

A chronically ill woman suffering from anorexia nervosa wrote an impassioned letter to a judge asking for her treatment to be withdrawn so she could spend her final days “doing nice things”, it has emerged.

The young woman told Mr Justice Cobb that she was “fully aware” of what was wrong with her and what the “effects of my wish to refuse treatments” would be.

The judge, who was told that the woman’s life was in “imminent danger”, ruled last month that she should not be force-fed or forced to have treatment following a hearing in the Court of Protection – where cases involving sick and vulnerable people are analysed – in London.

Read more: The genetics of anorexia: can it be inherited?

But the details of her letter that helped inform his decision did not emerge until yesterday, when Mr Justice Cobb published a written analysis of the case.

“Whatever time I have left I just want to live each day alongside my granddad and [siblings], who are my world,” she wrote.

“I want them to know ‘me’ rather than this illness and to have some nice memories of our time together.”

The judge said anorexia nervosa had dominated the woman’s life for the past 14 years. He said a “psychological dependence” on alcohol had caused “end stage” irreversible liver disease.

She had been trapped in an “increasingly destructive revolving door of treatment and recurrent illness” and had been admitted to hospital more than 45 times in 11 years – sometimes being detained under the provisions of mental health legislation.

An NHS trust had asked the judge to make rulings on what was in the woman’s best interests. Doctors said they thought it was in her best interests not to be force-fed or forced to have treatment.

Mr Justice Cobb, who described the case as “unusual and desperately sad”, said no one involved could be identified to protect the woman’s privacy.

He said the woman’s childhood traumas had left “deep wounds” and manifested themselves through her “psychological disturbance”. She had used her eating disorder and alcohol as “props to enable her to function”.

“This is an unusual and desperately sad case,” said the judge.

“So far as I can do so, I have endeavoured to put myself in the place of [the woman] and guided by what she has directly told me and others.”

He added: “I have reached the clear conclusion that I should not compel treatment for [her] anorexia.”

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