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ObesityThe European Court of Justice ruled ,last week, that in some circumstances obesity can be classed as a disability.  This means  obese workers whose weight hinders their performance at work is entitled to disability protection. Employers must make reasonable adjustments such as providing larger chairs or special car parking, and protect such employees from verbal harassment.  Providers of goods and services such as shops, cinemas and restaurants will also have to make reasonable adjustments for their customers, which might include things like special seating arrangements. The obese may be entitled to disability benefit in addition. Is this fair?

It is a fact that obesity does hinder daily activities. However it is, nearly always ‘self inflicted’. This leads to a lot of resentment. ‘Why should we pay more to help people who refuse to help themselves’ is a common sentiment.  Melanie Reid, a spinal injury patient, writes in the Times

‘Imagine a morbidly obese twenty something, after years of gallantry and doggedness in the cake shop, being entitled to the same rights as a soldier with several limbs blown away in Afghanistan.’

The ‘Rights versus Responsibility debate’ is an important issue in medical ethics. We all have the right to take risks with our health, to do unhealthy things such as smoke, over eat etc but is it fair to expect society [tax payers] to fund the consequences? Melanie Reid wrote

‘Does everyone now have a sense of entitlement to victimhood? We are medicalising society to the point where there is always a get out. No one has to take responsibility..’

Ethical problems can be thought of as conflict between the 4 ethical pillars.[See my book Medical School Interviews The Knowledge] In this case you have a conflict between Autonomy [the first pillar of medical ethics]; I have the right to do as I want versus Justice/fairness [the 4th pillar of medical ethics].

NICE has recently, just a couple of weeks ago, recommended bariatric surgery should be made available to a large proportion of obese people. We are getting fatter, over 2/3 rds of British adults are classified as over weight and 1/4 obese. Obesity is [excuse the pun] a large, growing problem with catastrophic consequences for the health and wealth of the UK!