The Fatslayer Chronicles

Would you want to be considered disabled, just because you’re fat?

A woman is threatening to sue the NHS trust that my best friend works for, under UK disability legislation, for violating her civil rights because she was a) counselled by an anaesthetist to lose weight before having knee surgery; b) not permitted to take a bath before the operation was performed, but was forced to take a shower instead; c) not provided with surgical stockings after the surgery; d) humiliated and distressed by the above alleged ‘fat discrimination’.

On the face of it, all of this sounds fair enough, but if you look at it from the Trust’s viewpoint, it paints a different picture.

The woman is 57 years old, and weighs 34 stones (476lbs). She has diabetes, hypertension, heart disease and emphysema. She smokes a pack and a half of cigarettes a day.

To address each of her complaints in turn:

a)     There was a very real possibility that she would have problems under a general anaesthetic, not just because of her weight, but also because of her associated health problems and her smoking. The consultant anaesthetist was acting in her best interests by informing her of this, and advising her to lose weight before submitting to a non-emergency procedure.

b)     The hospital bathtubs are more than twice as large as the average domestic tub, but were still not sufficiently wide enough to accommodate such a large lady. Nor were the hoists able to support her weight - they were only supposed to support weights below 30 stones (420lbs). Attempting to bathe her would have been dangerous to both her and the nursing staff. Again, in my opinion, the nurses were acting in her best interests. 

c)     The hospital supplies department contacted the manufacturers of the stockings directly to see if they produced stockings in such a large size – they didn’t. The risk of a surgery-induced embolism was high, but too-tight stockings would have exacerbated the risk, not reduced it. Again, the decision was made in her best interest.

d)     I guess I can’t speak for her state of mind, and I expect she DID feel humiliated and distressed – which was obviously not in her best interest…but was that entirely – or at all - the fault of the hospital?

This woman said – when interviewed on local radio - that the Trust had an obligation and duty to offer people with disabilities the same treatment and facilities as were offered to other able-bodied members of the public. I agree with her – but is the analogy correct in this case?

An ‘able-bodied’ person would also be counselled not to have non-emergency surgery if there was a significant likelihood that they would die under the anaesthetic.

With regard to the bath-tub, is the Trust acting in a discriminatory manner by not providing bathing facilities large enough to accommodate every conceivable body shape? Should they provide a super-sized tub just in case they get either a patient that’s seven foot tall or a set of conjoined twins who need to bathe together?

That would be overkill, right? The complainant’s body size is exceptional – so is it ‘discrimination’ to fail to cater for the exceptional? The lady admitted she hadn’t been able to fit into her bathtub at home for over twenty years – why did she feel it was her ‘right’ to be accommodated in hospital?

The hospital did it’s best to meet her special needs – they hired a super-strength pressure-relieving bed so that she would be comfortable, and brought in one additional nurse per shift so that she could be turned regularly in bed to prevent crud collecting in her lungs and helped onto the commode etc. Wasn’t that investment in her welfare enough?

Frankly, that knee-jerk reaction to head down the litigation route really sticks in my craw. The hospital did it’s best by her, and to my mind, the woman has to take some responsibility for her predicament. The hospital told her to lose weight before surgery and she refused – that was her choice, and surely she has to live with the consequences?

I’m not saying she’s to blame for being morbidly obese – there may be factors beyond her control, and who am I to judge anyway? Similarly, implying that she’s less disabled because she wasn’t born disabled or because she didn’t become disabled through injury (as said in one of the local newspapers) smacks of rampant judgmentalism to me – a way of saying she’s less deserving because she ‘brought it on herself’. The same people sitting in self-righteous judgement said that AIDS medication and treatment should only be offered to ‘innocent’ victims of HIV (haemophiliacs etc) rather than those that had brought the illness upon themselves through their ‘bad habits’. I HATE that kind of hypocrisy and smugness.

But whether we like it or not, the world is tailored to ‘normal’ people. And though disability legislation has quite rightly made companies consider the needs of non-able-bodied customers, they must be able to draw the line somewhere, surely?

Otherwise where will it end? King sized beds as standard on hospital wards? Bench-wide seats as standard on public transport and in theatres and cinemas? A constant fear of being sued if one fails to cater for every contingency?

I would imagine that many fat people would be horrified and appalled at being considered ‘disabled’. There’s enough of a stigma attached to simply being fat, without attaching the disabled label too. So in some ways I think this lady is doing fat folks a disservice by piggy-backing on the disabled legislation.

But when does obesity cross the line and become disability? Is it when your weight becomes so huge that you start to have physical problems (walking etc), or is disability also a state of mind?