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"But there should not be blanket refusals to operate on fat people" I don't know anyone who would disagree with this sentiment. And the article doesn't present

"But there should not be blanket refusals to operate on fat people" I don't know anyone who would disagree with this sentiment. And the article doesn't present any evidence that there are blanket refusals. Sure, the article presents a few anecdotes, but that's not enough to show that blanket refusals are happening on a larger scale. > You can inform people of the increased risks and possible outcomes and let them make their own decisions about their bodies. It's really not that simple. A medical doctor's mission is to help people and very specifically to "do no harm". When the data suggests that they are more likely to do harm by operating, then the doctor is following their oath by not performing a surgery.

lsy 10y ago
From the article: "A recent survey of more than 700 hip and knee surgeons confirmed Dr. Yates’s impressions. Sixty-two percent said they used body mass index scores as cutoffs for requiring weight loss before offering surgery." It sounds to me like "cutoffs" and "requiring" would indicate a blanket refusal, and 62% seems like a fairly large scale to me. What evidence are you looking for? Other common conditions can also increase risks of complications, and patients are routinely given opportunities to weigh those risks before deciding on surgeries. My suggestion isn't that the doctor throw his duties out the window, but that with high-BMI patients, those duties should not suddenly become more dictatorial than with other patients.
- vonmoltke 10y ago
  Some aren't. Patients with severe hypertension, for instance, are often categorically denied non-critical surgeries as well.
- asynchronous13 10y ago
  There's a difference between saying "You're fat, so we won't operate on you." versus "The pain that you hope to fix will become worse if we perform surgery on you." Surgeries that involve weight-bearing joints and bones are particularly sensitive to the mass of the patient (like the hip and knee surgeons surveyed). For heavier patients, the healing time is longer and the risk of additional pain after surgery is much much higher.

lsy 10y ago

From the article: "A recent survey of more than 700 hip and knee surgeons confirmed Dr. Yates’s impressions. Sixty-two percent said they used body mass index scores as cutoffs for requiring weight loss before offering surgery." It sounds to me like "cutoffs" and "requiring" would indicate a blanket refusal, and 62% seems like a fairly large scale to me. What evidence are you looking for? Other common conditions can also increase risks of complications, and patients are routinely given opportunities to weigh those risks before deciding on surgeries. My suggestion isn't that the doctor throw his duties out the window, but that with high-BMI patients, those duties should not suddenly become more dictatorial than with other patients.

vonmoltke 10y ago
Some aren't. Patients with severe hypertension, for instance, are often categorically denied non-critical surgeries as well.
asynchronous13 10y ago
There's a difference between saying "You're fat, so we won't operate on you." versus "The pain that you hope to fix will become worse if we perform surgery on you." Surgeries that involve weight-bearing joints and bones are particularly sensitive to the mass of the patient (like the hip and knee surgeons surveyed). For heavier patients, the healing time is longer and the risk of additional pain after surgery is much much higher.