Ethical dilemmas frequently arise in the treatment of clients with eating disorders, and clinicians regularly encounter an array of ethical challenges related to whether or not overt and covert coercive tactics should be implemented. In this paper, the authors provide an overview of perplexing ethical questions relevant to medical, nutritional and psychological treatment of clients with eating disorders including imposed treatment, enforced feeding, the duty to protect minors and adults, the determination of competence and capacity among medically comprised clients, and the effectiveness of coercive treatment for clients with eating disorders. The processes of ethical decision-making in terms of ethical principles, professional codes of conduct, the existing empirical literature and the use of a decision-making framework are explored. Taking a collaborative and client-sensitive approach, the authors outline and apply an integrative ethical decision-making model to facilitate clinicians' decision-making process.