Bariatric surgeries, procedures
that surgically alter the gastrointestinal tract to reduce eating capacity or
calorie absorption, are gaining popularity as a way to combat America’s
ever-widening obesity epidemic. Bariatric surgery has been shown to produce a
weight loss of up to 33% within a few years of the treatment, making it more
effective than either diet and exercise or dieting pills. But is it moral? The
American Journal of Bioethics recently conducted a survey of the various
objections to bariatric surgery from the standpoint of medical ethics.
There are several potential
objections to bariatric surgery. Some argue that bariatric surgery incentivizes
an unhealthy or immoral lifestyle. Because it removes the consequences of
overeating, it allows people who would otherwise exercise more self-control and
lead healthier (and more globally sustainable) lifestyles to indulge their
appetites without repercussion.
On the other hand, there are also
arguments against bariatric surgery that take the side of the obese.
Considering society’s pronounced discrimination against the obese (including
the phenomenon of “fatism” in the workplace), overweight people may feel
coerced into having bariatric operations even if they would otherwise be
comfortable with their bodies. This challenges the medical ideal of voluntary
consent.
Neither of these arguments,
however, is sufficient to render bariatric surgery immoral. While the first
argument takes issue with obesity because of the perceived immorality of the
choices that lead to it, this argument ignores involuntary forms of obesity
such as genetic obesity. The second argument ignores the fact that bariatric
surgery remains only one of many options for those seeking to lose weight
(whether out of personal desire or due to societal pressure).
What’s more, the benefits of
bariatric surgery, both to the individual and to society, are tremendous.
Bariatric surgery has a significantly higher success rate than traditional
weight-loss methods such as diet and exercise. Additionally, the cost of
bariatric surgery to the health-care system must be weighed against the cost of
the host of other operations that would be necessary to deal with the symptoms
of obesity, including diabetes and cardiovascular dysfunctions. A recent study in Finland reports a cost of
$45,000 for a gain of 7 quality-adjusted life years for bariatric surgery, compared
to a cost of $64,000 for a gain of 6.5 quality-adjusted life years for patients
undergoing surgeries that would have been prevented by bariatric surgery. It
appears that bariatric surgery is not only not immoral but in fact a superior
option that should be made more widely available to those suffering from
obesity.
Source: Bjorn Hoffman, "Stuck in the Middle: The Many Moral Challenges With Bariatric Surgery" The American Journal of Bioethics, 14 December 2010
1 comment:
I agree that bariatric surgeries to reduce the weight of obese people are ethically justifiable. The main concern people have is whether or not it is ethical to provide obese people with a “shortcut” to lose weight and still maintain their bad habits. Underneath this, the underlying concern is really whether or not obesity is a disease. People who believe that it obesity not a disease or a medical condition, but the result of ill-advised life choices believe that obese people shouldn’t receive shortcuts which cheapen the value of healthy eating and exercise. However, examining the issue more closely reveals that regardless of whether or not obesity is considered a disease, the best option for society and the individual is bariatric surgery.
First of all, obesity can be a result of medical conditions, such as hypothyroidism, and it can be the result of a genetic predisposition. Largely, no one contests that the people with these conditions should be offered bariatric surgery as an option – since it will alleviate something that is out of their control. Moreover, other benefits include, “resolution of diabetes, reduction in cardiovascular risk, and decreases mortality”. This, in turn, increases their productivity and quality of life and reduces their burden on the medical system, as other medical procedures are less frequently needed. Thus, there seems to be no downside to bariatric surgery if obesity is considered as a disease – so what makes it so different if obesity is not considered as a disease?
In reality, there is no difference. All the above benefits apply now as well, the only difference is that some people say that providing this shortcut to get out of obesity will incentivize bad health habits. If this were true, then bariatric surgery on obese people could be objectionable, but this is not the case. For instance, in from 2008 to 2009 the percentage of obese people in the US only increased from 62.2%-63.1% - less than a percent, which was the same time that the use of bariatric surgery to alleviate obesity was becoming more prevalent. As a result, there is no clear indication that bariatric surgeries incentivize bad health habits, as the rates of obesity remained about the same with or without the surgery. Moreover, bariatric surgeries are only undergone by .05% of the obese population in the US – again demonstrating their insignificance as any sort of incentive.
Therefore, with this in mind, it becomes evident that the main objection against bariatric surgery on obese people is merely hyped up, and of little consequence in the real world. Consequently, bariatric surgeries will only have positive effects on the individual, as well as society, so they are morally justifiable.
http://news.discovery.com/human/obesity-disease-debate-111017.html
http://www.healthgrades.com/business/img/HealthGradesBariatricSurgeryTrendsAmerHospReport2011.pdf
http://www.webmd.com/diet/news/20100210/percentage-of-overweight-obese-americans-swells
Post a Comment