Woman battling anorexia has been given the right to starve herself to death in landmark court decision.

A 29-year-old woman diagnosed with anorexia was on Monday granted the right to receive palliative care and starve to death, if she desires.

The New Jersey woman, known only as A.G., weighs 31 kilograms and has battled with the disorder for a majority of her life. When she was 13 she started purging, after years of comparing her body to those of her peers.

The controversial ruling comes after she spent more than two years in a psychiatric hospital, and was then transferred to temporary guardian Susan Joseph who was instructed to feed her artificially. A.G. gained approximately nine kilograms, but as a result of refeeding syndrome, she suffered heart failure, and ultimately pulled her feeding tube out herself. Since then, she’s consumed primarily diet soft drink and black coffee, as well as small bites of food.

Following A.G.’s heart failure, Joseph requested she be admitted into palliative care, but the state opposed it, arguing that her mental state rendered her unable to make her own medical decisions. Ceasing to force-feed her would be sanctioned suicide, they said.

Watch: Is anorexia genetic? Post continues after video.

But in court earlier this month, her lawyer argued that while force-feeding would keep her alive, it wouldn’t treat her disorder. Likewise, her psychiatrist testified that to force-feed A.G., who has the bone density of a 92-year-old, would be “cruel and torturous at this point.” Her doctors reiterated this sentiment, claiming it’s highly unlikely the woman will ever recover.

A.G.’s family have also reportedly said they’ve done everything possible to help their daughter recover, including psychological and medical interventions. Her mother has accepted the decision for A.G. to refuse food, saying she hasn’t been able to “take the treatment and thrive” at any point during her long battle.

“The thoughts of this whole process are running through her head and she has no peace,” said A.G.’s mother.

“She never seems to have a moment where she’s just relaxed. She’s tormented.”

During the court proceedings. A.G. said she refused to eat any food and is prepared to die. She believes any weight over 31 kilograms is too high, and that the incentive for those who want to force-feed her is to “make her fat.”

The landmark decision took over two hours to deliver, with Judge Paul Armstrong describing A.G.’s testimony as “forthright, responsive, knowing, intelligent, voluntary, steadfast and credible.” He argued she is mentally capable of choosing to deny food, and said she has “expressed an unequivocal desire to accept palliative care as suggested by her treating physician and the bioethics committee at Morristown Medical Center.”

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The landmark decision took over two hours to deliver. Image via iStock.

"This decision was made by A.G. with a clear understanding that death was or could be the possible outcome," he said.

In Australia, we have fairly clear legislation around when a person does and does not have the ability to make a medical decision.

According to the Centre for Eating and Dieting Disorders (CEDD), a psychiatrist will consider the following criteria if a patient refuses care:

1. Do they understand the information and do they understand the consequence of non-treatment?

2. Do they believe the information?

3. Are they able to weigh-up the information and arrive at a choice?

4. Are they cognitively impaired by severe starvation?

5. Are they delusional about the necessity of adequate nutrition, threat to life, and the need for medical intervention?

If the person does not meet all criteria, they are deemed unable to make a medical decision. At this point, medical professionals can utilise the Mental Health Act, which states patients can be detained as mentally disordered.

The CEDD claims that a person diagnosed with an eating disorder who is severely underweight will most likely satisfy the criteria for treatment under the Mental Health Act.

Listen to Meshel Laurie's interview with a woman who battled with debilitating anorexia. 

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