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09/30/2011 02:36 AM

Should drs refuse to treat morbidly obesepatients

Bettyg
 
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Should doctors be able to refuse to treat morbidly obese patients?

KevinMD's Take, September 28, 2011

By: Kevin, M.D. | September 28, 2011

Should doctors be able to refuse to treat morbidly obese patients?

It's a controversial question, and the answer, according to this emergency physician, is yes.

"If physicians want to decrease their risk in managing patients by excluding patients who are at higher risk for complications," he writes. "shouldn't they be able to do so? ...

The more that physicians who care for higher-risk patients are sued for less than perfect outcomes, the less that those physicians will be willing to treat higher-risk patients."

This stance has generated a lot of heated comments, but many doctors feel this way, especially in our adversarial malpractice climate. Until that changes, I would expect more physicians to be wary of taking patients prone to medical complications.

***

Media continues to portray early cancer screening in a positive light.

But according to this Australian physician, this ignores the cost, and potential harm, of these tests.

"Mass screening is seen as 'good' and there are constant calls for more funding for it," he writes. "The programs attract a “saintly” aura and any questioning will be met with shrill criticism and hostile accusations from the screening industry. Medical tests have benefits but also costs.

The current belief that more is better is not correct."

The costs include more expensive, and invasive, follow-up tests. Better balance is needed both from our newspapers and television newscasts to give information on potential harms, so patients can make a better-informed choice.

8 Comments

September 29, 2011

As a morbidly obese woman who just had a thyroidectomy, with no complications, I can tell you that if my surgeon had refused to operate simply because I'm fat, I would be in a world of hurt.

My surgery took 4 1/2 hours instead of the 3 hours she had planned, not because of my weight, but because my GP told me 4 years ago that my enlarged thyroid was "nothing to worry about".

Right, that's why it was so enlarged that it was almost wrapped around my windpipe and esophagus and made swallowing difficult.

Should my surgeon have refused to treat me, simply because I'm morbidly obese, even though I have NO co-morbidities and am metabolically healthy?

Deny care to people like me and you're possibly passing a death sentence on us (which, in this fat-phobic society, doesn't surprise me one little bit, I've gotten death wishes from all kinds of people who think I should die so they don't have to look at my disgusting fat body).

-- Posted by vesta44

September 29, 2011

There are obese individuals who have normal blood pressure, normal glucose levels and who exercise regularly. Certainly, they are not the norm -- however, they exist.

People come in many sizes and shapes. Medicine is the last place bigotry should exist or be tolerated.

-- Posted by m smith, M.B.A., B.S. Health Sciences

September 29, 2011

What BMI shall we use to decide who to treat? This is a subject just waiting for a good attorney that will find the "pot of gold" after winning a case against a physician who turns away an obese patient.

I can see a situation where one might have to refer a patient to a specialized facility but not to turn away a patient.

Try turning away someone with HIV or non english speaking. Better have a very good attorney.

-- Posted by robert frischer

September 29, 2011

If you refuse to treat a patient who arrives in the ER with an injury, symptoms of stroke or MI, or indication of serious illness, you face the possibility of a lawsuit if that patient dies or suffers disability as a consequence of your neglect.

Perhaps you would feel better about being sued for something you did not do than for something you did. Would you feel better knowing someone's spouse, parent or child had died as a consequence not of something you did, but of something you refused to do?

Does a patient's obesity make her less a human being, and responsibility for her death or disability due to your inaction thus easier to dismiss without guilt?

-- Posted by Beverly Richards-Smith, PhD

September 29, 2011

Hmm, the ED doc needs to remember that if the hospital gets any federal funding then he is obligated to see and stabilize any patient coming to the ED.

His job is to care for those who come to the ED seeking help; otherwise it is “dumping.”

What a scary thought that the ED doc could choose not to help you because of whatever reason he feels strongly about.

My husband is an ED doc and he would never turn anyone away; it would be unthinkable.

-- Posted by Molly Ciliberti, RN

September 29, 2011

I'd much rather see doctors require high risk patients to sign a waiver acknowledging their condition, the possible risks, and relieving the physician from liability due to complications or treatment failure, than to outright discontinue serving as the patient's doctor. There has to be something better than just cutting folks off when they most need assistance! On the other hand, one bad apple. . .how sad to see society becoming so self-serving. Nobody wins.

-- Posted by R Burns

September 29, 2011

Some stigmas are earned and their consequences well-deserved. Any analytic professional should have the right to make risk-determined decisions. And imposing a risk premium of one sort or another makes perfect economic sense.

If an artificial constraint, such as governmental regulation or institutional policy, prohibit the risk premium, then the professional should have the unquestioned right to avoid the risk altogether. In the case of the morbidly obese patient, by refusing to undertake administering treatment.

-- Posted by Mr. Grolsch

September 29, 2011

So if physicians choose to treat only those patients who are at low risk for complications, what does that say? Didn't we go though this fifteen or so years ago with physicians and dentists refusing to treat AIDS patients? Or what of gunshot victims or major trauma patients -- are they not, by the very nature of their injuries at risk for complications? Should only thin accident victims be treated? How exactly is this not about weight stigma? BTW, this is Weight Stigma Awareness Week

-- Posted by Cheryl Fuller, Ph.D.

http://www.medpagetoday.com/Blogs/28770?utm_content=& utm_medium=email&utm_campaign=DailyHeadlines&utm_source=

© 2011 Everyday Health, Inc. All rights reserved.

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09/30/2011 06:04 AM
Weasy
Weasy  
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I don't think anyone should be refused medical treatment but I can't stick up for the doctors here.

America is one of the most overweight, unhealthy, prescription engulfing countries in the world and it's simply due to what we eat.

I've seen these morbidly obese people on tv and all they do is eat loads of greasy, fatty foods, and drink tons of soda. That's a choice you chose to make.

The fact is that if we aren't eating whole organic foods that go into our stomach the same way it came out or off of the earth, we set ourselves up for disease.


10/01/2011 11:35 PM
Bettyg
 
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weasy, did you see dr. oz the other day this week, 1200 lbs.woman wants to be heaviest at 1800 lbs?? shaking my head!

bg


10/02/2011 01:44 AM
RavenLunatic
RavenLunatic  
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Weasy -

I agree with you when it comes to these people eating all of this crap food.

About 6 months ago I was in the grocery store. I was in pain, hanging onto the cart do to lower back pain, just trying to get what I needed & get out. A woman (about 400+) sitting in a motorized cart asked me to get a box of "Honey Buns" off the shelf for her & put it in her cart.

Normally, I would never say anything rude to someone who's over weight. You don't know what's going on in there life. Who knows.... They could be sick. Even if they're not & just gluttons, they have an addiction.

Well, that day I just flipped out. IDK if it was brain rage &/or physical pain but I lost it. I told the lady, "If you're too big to get up off the cart to get your own damn "Honey Buns", you obviously don't need them!!!"

Looking back, that probably wasn't the nicest thing to say to her but people need to take some responsibility in their life.

I've had my fair share of weight issues over the years do to thyroid/endocrine issues but I was trying to eat right. I sure wasn't buying boxes of "Honey Buns"!!!

Post edited by: RavenLunatic, at: 10/02/2011 01:44 AM


10/02/2011 05:48 AM
Weasy
Weasy  
Posts: 943
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- Betty

You know what, I did get a glimpse of that and it's just disgusting.

- Raven

Your story kind of made me laugh because I know the kind of people you're talking about but you probably saved her life

The one thing that drives me up the wall is that obese people are qualified as handicapped.

If ANYONE should qualify as handicapped, it's people with Lyme Disease

But I won't sell my pride away that easily!


10/02/2011 05:50 AM
Weasy
Weasy  
Posts: 943
VIP Member

I forgot to mention when I am in the checkout line. I always get a weird look because I have only fruits, vegetables, and some meat in my cart.

One lady was like "That's it?"

I'm just like to myself "What do you mean, this is the diet human beings are suppose to be on!"


10/02/2011 07:38 AM
beensLYMEd
beensLYMEd  
Posts: 235
Member

Oh. Lets not forget. That obese people r one of the most discriminated people in America

I have had thyroid issues for twenty years and have been under a hundred pounds at 5'10". And looked anorexic during the height of hyper thyroid.

Now am really overweight and can't move. I am on so much medication. I eat extremely carefully.

I know people must think I am a glutton as u said ...

But honestly I am not.

Just hurts a lot. I know when I was super skinny. I didn't look at overweight people and wonder what they were eating . I was worried about getting enough calories to sustain.

When I see big ladies with honey buns. I love them.

Being at the grocery store is horrible people r so pushy and always trying to get around me because I am moving too slow or reading labels

I hate labels. they r so complicated.


10/02/2011 08:08 AM
RavenLunatic
RavenLunatic  
Posts: 2673
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Beenslymed - I'm not dissing overweight people. Like I said, "I've had my own weight issues due to thyroid/endocrine issue." But I had to work hard just to maintain my weight.

I've always felt like I had to diet to maintain & starve myself to lose weight. I now know why. That's why I would "NEVER" insult an overweight person. I just don't think that when someone is 400+ lbs. they should be eating crap like "Honey Buns".

I'd love to be able to sit down & eat a big ol' chunk of chocolate cake w/ chocolate icing right now but the reality of the situation is, I can't. So... I don't.

People need to start taking more responsibility for their own health issues, instead of relying on their Drs. As most of us with "LD & Co." know all too well."


10/02/2011 09:16 AM
beensLYMEd
beensLYMEd  
Posts: 235
Member

Sorry. Guess I am more sensitive than I should be today. haven't been sleeping well.

And having weepy herx again.Sad


10/02/2011 10:33 AM
RavenLunatic
RavenLunatic  
Posts: 2673
Group Leader

Don't be sorry. I'm also sensitive when it comes to weight.

Like you, I've had my ups & downs. Sever weight issues as a child (107 lbs. @ 8yrs.old - 94 lbs. @ 16 yrs. old) I was tease/bullied/insulted my entire childhood.

After I gave birth to my DS, I then got sick with the "Avain Bird Flu". I put on over 60 lbs. in less than 3 months & steadily gained weight over the next 8 years. Only to finally found out I had thyroid/endocrine issues.

I know, all too well, how people are discriminated regarding their weight. There were many times I wanted to apply for a job/position & didn't because I knew I had to be 10x's better/more qualified to even be considered for the position. People will hire a thin person over an obese person any day.

People who are thin & have never had a weight issue will say this is not true but anyone who has been there knows it is all too true.

I'm sorry you're hexing & feeling so bad right now. I hope you start feeling better real soon, Sweetheart. {{{hugs}}}

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