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Review
. 2018 Jul;28(7):2078-2082.
doi: 10.1007/s11695-018-3301-1.

How Ethical Is Our Current Delivery of Care to Patients with Severe and Complicated Obesity?

Hilary Craig  1 , Carel le Roux  2 , Fiona Keogh  3 , Francis M Finucane  4
Affiliations
Review

How Ethical Is Our Current Delivery of Care to Patients with Severe and Complicated Obesity?

Hilary Craig et al. Obes Surg. 2018 Jul.

Abstract

Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics. We found that in relation to autonomy (i.e., the right to self-determination), beneficence, non-maleficence, and justice (i.e., the obligation to provide fair and equitable treatment to all patients), the current provision of bariatric surgical care fell short of meeting internationally recognized medical ethical standards. These findings have important implications for government policy and healthcare resource allocation. Respecting the individual's right of self-determination, to do good, prevent harm, and provide equity in access to services is paramount, even when that individual is obese.

Keywords: Autonomy; Bariatric; Beneficence; Ethics; Justice; Non-maleficence.

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Conflict of interest statement

H. Craig and F. Keogh declare that they have no competing interests. C. le Roux has received honoraria and travel grants and has served on advisory boards for Novo Nordisk, Johnson & Johnson, GI Dynamics, Fractyl, Herbalife, Eli Lilly, Sanofi-Aventis, Astra Zeneca, and Boehringer Ingelheim. F.M. Finucane has received honoraria and travel grants and has served on advisory boards for Novo Nordisk, Eli Lilly, Ethicon, Pfizer Inc., Sanofi-Aventis, Astra Zeneca, Merck-Serono, Boehringer Ingelheim, Janssen, and Novartis.

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References

    1. Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19.2 million participants. The Lancet. 2016;387(10026):1377–96. - PMC - PubMed
    1. Sturm R, Hattori A. Morbid obesity rates continue to rise rapidly in the United States. Int J Obes. 2013;37:889–891. - PMC - PubMed
    1. Reges O, Greenland P, Dicker D, Leibowitz M, Hoshen M, Gofer I, et al. Association of bariatric surgery using laparoscopic banding, Roux-en-Y gastric bypass, or laparoscopic sleeve gastrectomy vs usual care obesity management with all-cause mortality. JAMA. 2018;319:279–290. - PMC - PubMed
    1. James R, Salton RI, Byrnes JM, Scuffham PA. Cost-utility analysis for bariatric surgery compared with usual care for the treatment of obesity in Australia. Surg Obes Relat Dis. 2017;13:2012–2020. - PubMed
    1. Jennings A, Hughes CA, Kumaravel B, Bachmann MO, Steel N, Capehorn M, et al. Evaluation of a multidisciplinary tier 3 weight management service for adults with morbid obesity, or obesity and comorbidities, based in primary care. Clin Obes. 2014;4:254–266. - PMC - PubMed

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