HealthLawProf Blog

Editor: Katharine Van Tassel
Concordia University School of Law

Wednesday, October 24, 2007

Treatment of the Obese

Pandagon and Echidne have interesting articles exploring the treatment of obese and how that treatment reflects some people's views of ill health in general.  Echidne writes,

Something similar is visible on many discussions about health issues. An illness is seen as “deserved” if the patient ever engaged in any activity which is now known to be correlated with that illness, and the illness itself is now viewed as punishment for evil deeds. Illness becomes a moral condition and the search for its epidemiology becomes a court case where the jury looks for that one decision where the patient went wrong, the one sin for which the current pain and suffering might be a just punishment.

In some ways we have stepped out of the framework where illnesses were caused by demons and into the scientifically medical one. But in other ways we have brought those demons with us, transformed into a different type of an ethical judgment or into a search of a different type of causal explanation, and that little hidden demon is what allows us now to judge other people without feeling any embarrassment over doing so. After all, if medical science tells us that some patients “caused” their own illnesses, then it is simply natural that we, too, point out that causal mechanism in all sorts of daily interactions.

Amanda at Pandagon adds,

This kind of discourse on illness is on the rise lately, because conservatives who are opposed to universal health care are rapidly trying to redefine pretty much all illness as a matter of personal responsibility to avoid taking collective responsibility for the health and well-being of citizens. Even the horrible and surely unintended car accident of the Frost family became an attempt to talk about “responsibility”, as if all misfortune could be attributed to a failure of will. . . . .

This pity-then-acceptance curve puts fat activists in a quandary, because it’s widely accepted that being fat is in fact something you can help and therefore the onus is on the fat people to lose weight and not on the rest of us to treat them with decency. And understanding the arch of pity-to-acceptance, fat activists have put a lot of work into arguing that dieting doesn’t work, and that obesity is genetic. That tactic might work, but then again, it might not. One issue that’s going to keep coming up is that people successfully lose and keep off 10, 15, 20 pounds all the time, and erroneously think that a 20 pound loss for me can means a 150 pound loss for you. If you can disabuse people of that notion, then quite possibly the pity-than-acceptance route might work for fat activists.

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