Medical care for the morbidly obese is back on the radar.
Today this blog got several inbound clicks from a site where a bunch of apparent doctor haters have used one of my blog posts and the comments to the post as an example of how much the medical profession allegedly likes to bestow shame upon others. It seems that the discussion we had regarding whether it is ever acceptable to refuse medical care to morbidly obese patients was something that Ms. Marianne’s readers were cautioned that they may not be able to “stomach.”
The author and most of the people who commented to her article seem to believe that they have the right to demand that any doctor at any time must provide any type of services to them that they demand. Whether or not the doctor is comfortable providing those services or whether the doctor even has the knowledge and training to provide those services is irrelevant. Any doctor who doesn’t agree to their demands is hated and publicly shamed. This doctor who chose not to treat patients weighing more than 200 pounds was one example of their wrath.
I left a comment to Marianne’s rant back when she first posted it.
I don’t remember the comment verbatim, but the gist of my comment was that there are specialists for a plethora of conditions who provide care to patients when other providers are uncomfortable caring for those conditions – HIV, diabetes, organ transplants, ophthalmology, etc. Why shouldn’t doctors be able to refer obese patients to other physicians more experienced in caring for obese patients?
In addition, there is no “right” to force any person to provide you with any services against their will. The Thirteenth Amendment to the Constitution addressed that.
Finally, I noted that when there is a bad outcome related to a patient’s obesity, one of the first things that a plaintiff’s attorney will allege is that the patient should have been referred somewhere else.
My comment was never approved. Non-conforming, I suppose.
Today there also happened to be an article in the NY Post – linked by the Drudge Report – about how a morbidly obese woman with multiple health problems traveled to Hungary for a month-long stay in their family vacation home. When she tried to board a flight back to New York to resume her medical treatment, the airline refused her because she had gained water weight and could not be safely strapped into three seats. The airline tried to make alternate arrangements for the patient’s travel back to the US, but those plans also fell through due to the patient’s size.
There was no mention that the woman ever went to a hospital for care of her medical problems while trying to secure travel back to the US. Both the patient and her husband were quoted as saying that they “didn’t trust” doctors in Hungary.
Nine days after first attempting to return to the US, the woman died.
Difficult situation. Comments to the article were mixed. Some people blamed the patient for allowing herself to become so obese. Others blamed the airline because it was able to get the patient to Hungary and then left her stranded there.
This case illustrates the point that I was trying to make in my previous post about providing medical care to morbidly obese patients. At some point, the safety and well-being of the patient and of others must be taken into account when deciding whether to provide care. These decisions are made all the time in medicine. A patient with severe lung disease may be deemed too great a risk for surgery. The doctors aren’t “discriminating” against people with lung disease, they are making a decision that the risks of surgery are too great given the patient’s condition. Some orthopedists choose not to perform knee or hip replacements in morbidly obese patients. Again, not “discrimination,” but rather the significantly increased risk of complications in morbidly obese patients.
In the Hungarian patient’s situation, what if the patient suffered an injury on the plane because she wasn’t able to be properly restrained? What if the patient had a medical emergency and died on the plane over the Atlantic Ocean because of her untreated medical conditions? Would these same people then point fingers at the airline for allowing the patient to fly in the first place?
Rather than engage in a rational discussion about the issues, some people would rather sensationalize, cry discrimination, and call names.
Something about the patient’s situation just doesn’t make sense to me.
I question how much “water weight” the patient gained during her vacation.
I also wonder whether the patient and her husband checked into the flight restrictions that might be imposed on the patient before taking their trip.
And why it was appropriate for the patient and her husband to discriminate against all doctors available to provide them medical care in Hungary solely because of the doctors’ national heritage?
Apparently “doctor hating” is still socially acceptable.
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