topic Re: Should Doctors be Allowed in Community Spirit

Should Doctors be Allowed

grandmoon — Sun, 03 Nov 2013 23:16:18 GMT

To deny surgery to patients who won't follow their direction. ??

A neighbor is complaining that the surgeon has refused to operate on her.

The doctor wants her to attend exercises in the hospital pool and to also loose some weight before he will do the operation.

She has refused and he said that he feels that the operation will not be successful unless she does.

Re: Should Doctors be Allowed

*crikey*mate* — Sun, 03 Nov 2013 23:22:57 GMT

Yes.

Re: Should Doctors be Allowed

siggie-reported-by-alarmists — Sun, 03 Nov 2013 23:26:38 GMT

Yes, he should.

He has made this suggestion for her benefit....why on Earth would she refuse?

Re: Should Doctors be Allowed

freshwater-2 — Sun, 03 Nov 2013 23:27:36 GMT

If she doesn't give a darn about her health, why should the doctor?

I seem to remember there was a court case on this issue not so long ago.

Not sure of the facts......but the patient died in the interim and the rellies sued the doctor.

The doctor won based on his prior advice to the patient and her refusal to comply.

Maybe somebody else has a better memory of it than I have.

Re: Should Doctors be Allowed

the_hawk* — Sun, 03 Nov 2013 23:31:16 GMT

Doctors want the odds of success stacked in their favour of a successful outcome when they operate and not have to deal with all the paper work when it all goes wrong because a patient was over weight, smoked or had high blood pressure and refused to prepare for an opp

Re: Should Doctors be Allowed

polksaladallie — Sun, 03 Nov 2013 23:33:40 GMT

The problem is that there is an extremely limited health budget, and a team of professionals (in the public system) confer as to who on the long list is the most deserving of high cost treatment first, then next, etc.

Re: Should Doctors be Allowed

*crikey*mate* — Sun, 03 Nov 2013 23:34:09 GMT

A doctor takes an oath to "do no harm" (or do I just watch too much TV?

If in his "expert" opinion, he determines that he will cause harm (putting their life at further risk) to the patient by operating, then why should he operate, wouldn't that be negligence on his behalf?

It would also be negligent if the doctor determined that his skills were not sufficient to perform the operation under particular conditions and then proceeded.

And in this day "of lets sue our own shadow because it's stalking me", can anyone blame a doctor for taking precautions to limit himself from liability?

Re: Should Doctors be Allowed

grandmoon — Sun, 03 Nov 2013 23:53:29 GMT

When I asked why she wasn't going to the exercise she said "It too far to travel and the time doesn't suit me." She also believes that he doesn't have the right to tell her to loose weight.

Re: Should Doctors be Allowed

azureline** — Sun, 03 Nov 2013 23:57:21 GMT

She must not want the operation?

Re: Should Doctors be Allowed

cherry*135 — Mon, 04 Nov 2013 00:01:47 GMT

Yes Dr is right. She can try another Dr if she wants to.
If there are more risks operating on an overweight person the Dr's are making the right decisions.

Get your neighbour to look uo the case freshwater mentioned. It was this year.

Re: Should Doctors be Allowed

*crikey*mate* — Mon, 04 Nov 2013 00:38:43 GMT

Has she told the doctor why she wishes to be non compliant with his advice/recommendations and have either of them attempted to find an alternative form of exercise or weight loss management program?

This is an American Article, but it gives insight into how and why this kind of situation should be managed.

Re: Should Doctors be Allowed

cherry*135 — Mon, 04 Nov 2013 00:47:53 GMT

This is the case freshwater mentioned

An epidemic of obesity is engulfing Australia, and Luis Almario's case raises intriguing questions about personal responsibility versus the medical duty of care.

http://www.abc.net.au/news/2013-08-26/overweight-man-luis-almario-legal-battle-prompts-obesity-warning/4913292

Re: Should Doctors be Allowed

imastawka — Mon, 04 Nov 2013 00:55:14 GMT

I don't much care for the legalities of the situation. But the doctor has

told her to lose weight. Simply scare the living daylights out of her

and tell her there's some chance, if she doesn't heed the doctor, that

she may very well die on the table. All because she couldn't be bothered!

Re: Should Doctors be Allowed

shoptilludroptara — Mon, 04 Nov 2013 00:57:11 GMT

yes

i know when i had to have an operation i was asked by my doctor to stop smoking for 2-4 weeks before the op

was hard for me to do but i did it to improve my chances with the op

if they cant get to the place and for the time then make new arrangements with the doc

for somewhere closer at a better time

and yes the doc has the right as he is the one who would be performing the op

the neighbour should wake up and do the right thing and not winge about it

tara

Re: Should Doctors be Allowed

imastawka — Mon, 04 Nov 2013 01:01:17 GMT

Sorry am, but that article is about doctors not treating the man for obesity.

The neighbor is being treated for some other complaint and the doc wants

her to lose weight so he can operate.

Re: Should Doctors be Allowed

purple_haize — Mon, 04 Nov 2013 01:10:00 GMT

If she is not prepared to do what the dr. suggests, why bother going to the dr. at all.

Re: Should Doctors be Allowed

***super_nova*** — Mon, 04 Nov 2013 04:11:56 GMT

When I was diagnosed with cancer it took couple of weeks before they had a bed for me so I could have my op. When i got there 3 beds on the large ward were occupied by grossly overweight patients who were so fat that it was impossible to find their vein to get some blood for tests and they were too big to operate on. All 3 were there already some weeks, they were on strict diet and the doctors were hoping that they shed some kilos and the op will be possible. But considering that at least one of them had visitors bringing food, I did not see much hope for that. Every day, several times a day, the nurses tried to get some blood but just could not. These patients also had dangerously high blood pressure, and were pretty much bed bound.

I imagine operating on such people would be very difficult; first unless you can get the test done you do not know what exactly you are facing, and what what if during the op they need quick transfusion?

Fortunately, my cancer did not spread into my lymph nodes, but it could easily happened in that time I was waiting for my operation. I wonder how many peoples' illnesses do get worse while they wait for beds occupied by overweight people?

Re: Should Doctors be Allowed

cherry*135 — Mon, 04 Nov 2013 05:28:34 GMT

@imastawka wrote:
Sorry am, but that article is about doctors not treating the man for obesity.
The neighbor is being treated for some other complaint and the doc wants
her to lose weight so he can operate.

It is still applicable for the neighbour in the OP.

personal responsibility versus the medical duty of care.

It is the patients personal responsiblity to lose weight as informed by her Doctor,if she is to have the operation.

It is the doctors medical duty of care not to operate on very overweight people (with the exception of emergency operatons) as it is more dangerous....the surgery, the anaesthetically and recovery takes longer.

If this women died or got seriously incapcitated due to not being allowed to have the operation ..could she sue the Dr. for not operating on her.

No, because she did not follow the Dr's advice.

Re: Should Doctors be Allowed

cherry*135 — Mon, 04 Nov 2013 05:32:28 GMT

The main point in the story in the link was:

But the payout was overturned after Mr Almario's GP argued, on appeal, that his patient had been warned to lose weight.

Re: Should Doctors be Allowed

siggie-reported-by-alarmists — Mon, 04 Nov 2013 05:50:42 GMT

My guess is this is an operation for Obesity.

For an operation like that you would need to be highly motivated...... She might have proved to him that she is not.

From doing some reading -

the following conditions need to be met for someone to be offered weight loss surgery. You need:

To have a BMI of 40 or more, or have a BMI between 35-40 plus a health problem that could be improved if you lost weight. For example, high blood pressure, type 2 diabetes, severe problems with your mobility, sleep apnoea (difficulties with breathing whilst asleep), etc.
Already to have been seen and treated by a specialised obesity team.
Already to have tried all other ways of losing weight for at least six months with no success. These include changes to your diet, an increase in your physical activity levels and treatment with medicines to help you lose weight.
To have no health problems that may make the operation dangerous for you.
To be able to commit to the long-term medical follow-up that is needed after weight loss surgery.
To have treatment and follow-up by a team of experts specialised in weight loss surgery available to you.