Factitious illness: A multidisciplinary consideration of ethical issues

Case histories of two women with surreptitious self-induced vomiting were presented to a multidisciplinary conference which included representation from the disciplines of psychiatry, internal medicine, law, nursing, and anthropology. Ethical issues including the topics of confidentiality, responsibility to the patient, and the relationship to third party payers were discussed. The medical and legal viewpoints were frequently at variance, in unexpected ways.