A 19-year-old woman with anorexia nervosa, restricting type, presents with a BMI of 14.2, heart rate of 42, and QTc of 502 ms. She has been medically cleared for psychiatric admission but refuses inpatient treatment, stating, 'I know the risks, I've read everything about refeeding syndrome and cardiac arrest, but this is my body and my choice.' She scores within normal limits on a standardized capacity assessment tool, she can articulate the risks, apply them to her situation, reason about alternatives, and express a clear preference. Her parents, who are not her legal guardians as she is 19, are pleading with the PMHNP to hospitalize her involuntarily. The PMHNP must navigate the conflict between respecting autonomy and preventing a potentially fatal outcome.