By the nature of their illness, many if not most patients with anorexia nervosa are treated against their will. This article explores the issue of patient autonomy and right to treatment refusal in the light of justified paternalism as well as a more enriched understanding of autonomy in the context of relationships. A summary follows on the research on patients' perceptions and response to involuntary treatment. The conclusion addresses the importance of human values intrinsic to the quality of a clinical relationship as determinant for patient recovery and professional satisfaction.