Bariatric surgery.
Also known as weight loss surgery.
A lot of people, myself included, sense something ethically wrong with
this. Most objections have to do with
the fact that obesity is not a disease, and furthermore it is (for the most
part) self-inflicted. Thus it seems that
bariatric surgery is almost a form of cheating: while the rest of the world
struggles with exercise and diet, you can just go to sleep for a couple hours
and wake up with the ideal beach body! But
what about if someone’s life is at stake?
For patients who acquire Type 2 diabetes, obesity becomes a
disease. In cases like this, when
aesthetics are not the motive, is bariatric surgery ethically permissible?
Type 2
diabetes, which is linked to obesity, can cause life-threatening complications
including high blood pressure, heart disease, strokes and kidney failure. Currently in the United States, there are
more than 20 million diabetes patients.
The most common advice these individuals receive is to focus on
improving diet and exercise. Often,
these recommendations bring about negligible improvement.
However, last spring, Denis Grady
of the New York Times reported in the article “Surgery for Diabetes May Be
Better Than Standard Treatment” that medical studies have shown that surgery
may be more effective than standard treatments in combating Type 2 diabetes. Patients who underwent this new surgery,
“which stapled the stomach and rerouted the small intestine” (Grady), lost as
many as 100 pounds and subsequently needed fewer medications. Furthermore, many experienced drops in
cholesterol and blood sugar, and some enjoyed total remission.
Though this form of bariatric
surgery has been performed before in the United States, those individuals who
opted for it had to pay for the operation personally if their insurance failed
to cover it. This is a serious
investment as the surgery costs between $11,000 and $26,000 and has significant
risks “[. . . ] including infection, nutritional deficiencies, bone loss and
surgical problems [. . .]” (Grady). Nevertheless,
in the near future, bariatric surgery could potentially be publicly funded and
be offered on a wider basis to any individual with Type 2 diabetes.
Though bariatric surgery is not technically a
form of plastic surgery, the relevant ethical and legal considerations are
similar. Accordingly, while many may
object to bariatric surgery on moral grounds, if a patient is able to pay for
it out of his or her own pocket (and not that of the public healthcare system)
bariatric surgery will probably remain a legally permissible option. However, the question remains of whether or
not patients with Type 2 diabetes should be eligible to receive this surgery
even if they (or their private insurance companies) cannot pay for it
independently.
Considering
the costs and risks involved, bariatric surgery should certainly not be the
initial treatment received by Type 2 diabetes patients. In fact, even relying on bariatric surgery as
a last resort is risky because this could deter patients from combatting
diabetes through natural weight loss methods.
All individuals with Type 2 diabetes should first be advised to follow
the traditional regimen of exercise and healthy eating habits.
Nevertheless, bariatric surgery
should not be ruled out entirely because it does have the potential to save
lives. Thus it seems that if a patient is
at severe risk and proves to have vigorously attempted to lose weight over a
sustained period of time, but still is unable to make headway, that individual
should be eligible to apply for publicly funded bariatric surgery. In all cases, this option must be thoroughly
regulated, and qualification must be decided on a case-by-case basis. While surgery may still be the “easy route”
compared to the strict lifestyle choices that most have to make to combat
obesity and Type 2 diabetes, it is better to give the occasional break than
condemn someone to imminent death. Therefore,
when the circumstances are right (which should be a rare occurrence), I believe
bariatric surgery is both legally and ethically acceptable.
1 comment:
You make a very interesting point about the ethical incorrectness of bariatric surgery used to treat obesity. Appealing to the fact that obesity is not a disease, you claim that aesthetic surgery, which bariatric surgery could be categorized as, is a form of cheating. Everyone else has to struggle, while the patient gets a quick fix!
But is there actually anything ethically wrong with aesthetic surgery? I would argue no. Competent adults, i.e. those who possess autonomy, have the right to choose whether or not they undergo medical surgery. Just as they can choose what kind of food to eat, which piercings or tattoos to get or if they should have their wisdom teeth pulled out, patients are free to decide what procedures they want to have done. It is, of course, vital that the patient is fully informed about the risks associated with the operations, and the doctors should ensure that the patients do not have too high expectations on the results.
Plastic surgery for purely aesthetic reasons has benefits for the patient – increasing their self-esteem and self-image is usually their motivation, as body image is highly valued in today’s society. (Whether or not this is a good value for society to hold so highly is a separate issue…) Bariatric surgery goes one step further. Not only does it improve one’s body image, but it also increases the health of the patient – it reduces high cholesterol, high blood pressure, cardiovascular problems, the risk of liver disease, and the list goes on. This would surely make bariatric surgery even more ethically permissible than plastic surgery.
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