US Docs Dismiss Disability Claim for Obesity to Avoid Litigation?
Thursday, June 18, 2009
So yesterday, as I huddled with the former, present and incoming Presidents of The Obesity Society and other Council members in a hotel meeting room just minutes from Washington DC’s Reagan Airport, to help select the next Executive VP for the Society, the American Medical Association, at its annual general meeting in Chicago, overwhelmingly and bizarrely voted to reject obesity as a disability.
In the argument I gleaned from the various press releases on this issue, it appears that the docs were afraid that if obesity were recognized as a disability under the Americans with Disabilities Act, then raising the issue of weight with a patient who did not want to hear about it could be interpreted as discriminatory and would potentially open the gate to litigation.
Thus the docs argue, that not recognizing obesity as a disability would only be in patients’ best interests, as it would allow them to address this issue and continue offering obesity counseling and treatments to their obese patients.
Critics however say that all the doctors are afraid of are lawsuits by people who “chose” to be obese and don’t want to hear about having to lose weight.
Not being a legal expert, I can only hope that I am missing some nuance here which explains this seemingly bizarre decision, as there is no doubt that severe obesity can be extremely disabling and I have yet to meet a patient for whom severe obesity is a consequence of simply making poor “choices”.
I definitely know that the 1000s of patients currently on a waiting list for our bariatric program are desperate for help and that most would probably consider the fact that they have to wait longer for help than patients with other “lifestyle” diseases like heart attacks, stroke, diabetes, chronic lung disease, or joint problems, as blatant discrimination and perhaps a far better reason to call on the courts than potentially being labelled with a disability.
I truly wonder whether, with the new-found confidence about not being sued, US docs will now roll up their sleeves and aggressively treat obesity in patients who need treatment – I am certainly not holding my breath.
AMS
Edmonton, Alberta
Thursday, June 18, 2009
An interesting turn of events in the US by the AMA. I too am not a legal expert and therefore may be missing something. I write this response as an occupational therapist and an emerging researcher in the area of obesity and participation. It is my understanding that if a health condition or state is recognized as a disability it offers an avenue of support and resources for those who experience the health condition as disabling. If the AMA looks at disability as the Americans with Disability Act outlines, it will see that factors in the environment such as physical barriers or limited access to public spaces can create disability. Persons with obesity experience these limitations routinely. Recognizing obesity as a state that may be experienced as a disability opens the door for policy changes that include access for bodies that fall beyond the ‘typical’ size. I encourage anyone who is trying to make decisions about the disability status of obesity to consider frames of reference that identify social, environmental and personal factors that contribute to the experience of disability for persons with obesity. The literature is out there and will help inform decisions that will open access for people and provide options that respect the multidimensional, complex nature of obesity. MF
Sunday, June 21, 2009
I believe that the main reason for the vote is that if obesity is recognized as a disability, doctors will have to reasonably accommodate it. This means expenditures for equipment, adjusting attitudes and other inconvenient things. Currently, under the ADA you have to demonstrate that your obesity is caused by something outside your control.
Good luck with that, because whenever you protest that you are eating properly and getting exercise, the assumption is that you are lying because you couldn’t possibly be that fat unless you are shoveling in junk.