Whose rights?
Amy Hamm in The National Post a couple of weeks ago:
Is it discrimination when doctors make care decisions that account for a patient’s extreme obesity? In British Columbia, astoundingly, it might be.
A Canadian woman who identifies as an “unapologetically fat intersectional feminist” won her bid to bring an obstetrician to the B.C. Human Rights Tribunal (BCHRT) for alleged discrimination on the basis of her size and body mass index (BMI), of 46, after the physician referred her to a high-risk birth centre during her pregnancy.
Sigh. He’s a doctor; he’s an obstetrician. He’s not some random person shouting insults, he’s not a bunch of people bullying her, he’s a doctor whose job it is know what’s a risk and what to do about it.
It’s also true that losing weight is not a simple thing, and for some or many people it just isn’t possible. The body fights back and tweaks the metabolism so that losing weight becomes more and more difficult, which eventually means it’s impossible.
Does it follow that the doctor should not have referred the woman to a high-risk birth centre? It does not. Whether she’s high risk or not is not a political question, it’s a medical one. It’s his job to make that call; it would be malpractice not to.
[T]he BCHRT has expressed an interest in exploring the “social construction of disability” in the forthcoming hearing. The tribunal’s latest ruling states that “disability under human rights legislation, including under the Code, extends beyond biomedical conditions and functional impairments to perceptions and stereotypes,” apparently including stereotypes about being fat.
Blah blah, but that won’t help the woman and/or baby survive the birth.
Glaringly absent from Lindberg’s entire case is any discussion of an infant’s right to a safe delivery guided by evidence-based care. The hospital where Lindberg wanted to give birth is classified as “low risk and without the benefit of specialized staff and equipment,” according to Fraser Health Authority. Obesity during pregnancy is linked to numerous health risks for both the mother and baby, including gestational diabetes — which Lindberg developed and required insulin for — birth defects, preterm birth, stillbirth, and a difficult delivery on account of the infant being oversized. That the human rights tribunal even mentioned, in its latest ruling, that Lindberg’s baby was born “without complication” can be none other than an admission that all parties recognize the risk that was inherent in her birth.
“Born without complication, no thanks to us.”
Lindberg got lucky with a healthy baby. Let’s hope her child does not require future therapy for the trauma of discovering that her mother fought so hard to prioritize “fat activism” over her own safe entry into the world. Because that is what this case ultimately comes down to: a fat activist performing a malicious and attention-grabbing stunt.
At the expense of her passenger.
How the hell was the doctor to know that ahead of time? This approach means the necessity of a precaution is judged retroactively. Madness.
I agree, that’s madness. Doctors aren’t going to be able to do their jobs if they are expected to indulge their patients’ fantasies instead of following accepted medical practice. Why would any woman want to risk the life and health of themselves and their own baby because they feel insulted by the fact that obesity is a health risk?
I didn’t like being told that I would have to change my diet when I suddenly became obese* and diabetic; but I didn’t take it as a personal insult! I just did as I was told; after all, that’s why we see doctors, isn’t it? Because they know things we don’t. Well, the good ones do! (I’ve had my share of dreadful ones, to be honest). It worked; I changed the way I ate, lost the excess 30kg, and got rid of the diabetes.
Was it easy? Pretty much. Do I miss everything I used to eat? Hell, yes! But enough to want to go back to being obese and diabetic? Hell, no! Just look at the list of the horrible things diabetes does to a person! Who would choose them just in order to carry on eating the same diet? Actually, I know the answer to that, sadly. A family acquaintance, younger (and in most ways much healthier) than I was, also faced with changing his diet or having diabetes, inexplicably chose the disease. His decline over the next few years was dreadful, and it ultimately killed him. But at least he got to eat all his favourite foods, right? Sigh.
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(*BMI of thirty – 50% heavier than I ought to be. I can’t imagine getting heavier than that, and not for any feelings of moral superiority – I genuinely don’t understand liking the stress of carrying all that excess weight)
Tigger, you were lucky that you were told to change your diet. When I was diagnosed with diabetes I had to suggest to the GP that maybe some dietary advice would be a good idea. His response was something along the lines that he could refer me to a dietician if that was what I wanted almost as it was some sort of imposition. I love medical science (without it I would probably be dead) – medical practitioners not so much.
Despite getting lots of exercise and being far from overweight, I turned out to have diabetic levels of A1C blood sugar. My doctor did put me on metformin, but also immediately sent me to get some advice on changing my diet.
I don’t know if living in Canada is part of the difference, but I keep hearing bad things about US health care.
Francis Boyle, you have been unfortunate. There are great medical practitioners in the US, and I have been fortunate to have had two in succession. My doctor is treating not only my diabetes but my asthma as though they are something to be concerned about, and spends time each visit to make sure we’ve covered everything I’m concerned about. He even takes my psoriasis as something serious, which is good when it’s so bad you can barely walk.
And he’s an extremely pleasant human being.
@iknklast
But I’m in Australia. We supposed to have (more or less) free healthcare for all. It is (again more or less) completely free for the unwaged and therein lies the problem. If you have two classes one of those will end up with second class service and it won’t be those paying even if that payment is more or less token. Plus there’s the Australian national myth that we’re a classless society. People naturally form hierarchies and when you enforce a counter-factual myth that tendency will manifest in some other way – in this case as a contempt for the underclass, the bludgers in the Australian vernacular.
Well, at least, the metformin is free. It just a pity that it took the system 15 years to diagnose my need for it.