I wish I could say I was surprised. After decades of assertions that judgmentalism has no place in medicine, we have recently seen advocacy for a return of such judgmentalism aimed at a different cadre of patients—specifically, the obese and smokers—based on the greater likelihood of spending medical resources. Now, some doctors in Florida are actually imposing weight limits on the otherwise healthy women they will take as patients. From the story:
In a nation with 93 million obese people, a few ob-gyn doctors in South Florida now refuse to see otherwise healthy women solely because they are overweight. Fifteen obstetrics-gynecology practices out of 105 polled by the Sun Sentinel said they have set weight cut-offs for new patients starting at 200 pounds or based on measures of obesity — and turn down women who are heavier. Some of the doctors said the main reason was their exam tables or other equipment can’t handle people over a certain weight. But at least six said they were trying to avoid obese patients because they have a higher risk of complications. “People don’t realize the risk we’re taking by taking care of these patients,” said Dr. Albert Triana, whose two-physician practice in South Miami declines patients classified as obese. “There’s more risk of something going wrong and more risk of getting sued. Everything is more complicated with an obese patient in GYN surgeries and in [pregnancies].”
Hmmm. But couldn’t the same be said about women who are anorexic, diabetic, HIV positive, or have had multiple abortions?
This isn’t the same thing as medical conscience—in which the procedure is objected to, not the patient. And I don’t think we can force doctors to take patients into their care (although a California fertility doctor was sued when she didn’t want to artificially inseminate a lesbian and the courts, in effect said to the patient, “Go git her!”). Moreover, I have some sympathy for doctors who practice defensive medicine and the worry about lawsuits. But do we really want people to have to pass a quality control test before being accepted as patients?
