Body positivity has challenged the conventions of traditional healthcare, showcasing that body shape and size have little correlation with bodily health. Nevertheless, detractors of body positivity have persisted in their shaming language and behaviors, even suggesting that larger bodies are an undue burden on the healthcare system.
This presents a unique opportunity to address body positivity detractors and a lagging healthcare system that fails to acknowledge body positivity. Healthcare systems can work toward being more body positive by allowing patients to opt out of tests and treatments that are weight-based and/or obesity-related. For example, suppose patients wish not to be weighed, or take pain/inflammation/blood pressure medication, or accept diabetes treatments, all in the name of body positivity. In that case, they should be permitted to opt-out.
Opting out of obesity-related testing and treatment can safeguard a patient’s desire to remain body positive regardless of how their health progresses. Medical intake forms would need only add a question about opting out of obesity-related testing and treatment, followed by a more comprehensive form if and when necessary. A small addition to medical intake forms could go a long way in demonstrating solidarity and an acceptance of body positivity.
Despite the simplicity of adding a question to medical intake forms, the complexity lies in the potential consequences. Opting out of obesity-related testing and treatment one day would not mean that patients could not opt back in in the future if they desire. However, insurance companies would likely have a field day by having the leverage to argue that obesity-related testing and treatments would not be covered if a patient has ever opted out, placing the burden of proof on the patient to show that the opt-out period did not contribute significantly to the need for obesity-related testing and treatment during the opt-in period.
Insurance companies would not be the only entities struggling with ethical dilemmas. Doctors, nurses and other medical practitioners could find themselves in ethical dilemmas, potentially violating the Hippocratic Oath of doing no harm. What medicine deems physical harm could be a mental health benefit since body positivity is directly geared toward self-love. An evolution of the word “harm” in this context would require a spectrum-based cost-benefit analysis of how much physical harm is acceptable for mental health and how much mental harm is acceptable for physical health.
Further clouding the Hippocratic Oath would be withholding seemingly necessary medical interventions. If and when an opt-out patient experiences significant discomfort, will the medical practitioner respect the patient’s opt-out decision? If an opt-out patient is incapacitated, will the medical practitioner respect the patient’s do-not-resuscitate order? Luckily, precedents are set, and medical practitioners can be held legally liable if they fail to follow a patient’s DNR order. Precedents are also set for culturally competent healthcare (Jehovah’s Witnesses not accepting blood transfusions) that have paved the way for body-positive healthcare and opting out of obesity-related testing and treatment.
A simple solution, a cavalcade of complex consequences, this topic is far from cut and dry. Many may suggest that having the option of opting out of medical care can be archaic. Others may find that body positivity, cultural competency and social justice take priority over medical care. Free will has pros and cons, and sometimes regretful decisions may be made. The question is, should people be protected from making regretful decisions, or should they be left to deal with the consequences of having made them?
