Caring for Fat Patients: Bioethical Considerations Surrounding the Duty of Care

Healthcare providers’ (HCP) duty of care explains what HCPs owe to all their patients, but this thesis will focus on how the duty of care informs the treatment of fat patients. Currently, the foundation of the duty of care is rooted in a set of principles enumerated by the American Medical Association. This current conception of the duty of care fails to provide basic protections against harm to fat individuals, primarily because it is unable to prevent the negative attitudes HCPs have about fat people from permeating healthcare. The negative attitudes HCPs have about fat patients stem from a societal emphasis on framing fatness as an individual moral failing as opposed to a systemic problem. The social narrative around fatness falsely claims that fat people choose to be fat and that they have a personal responsibility to choose otherwise. This framework causes harm to fat patients through the negative attitudes of HCPs. These harms include a decreased quality of healthcare, damaged relationships between providers and patients, mistrust of diagnoses, and much more. After exploring the harms endured by fat patients and the failure of the current duty of care to protect fat patients from these harms it will be clear that a revised duty of care is needed. The revised duty of care will be constructed from a new set of principles combined with increased educational standards for all providers. The new set of principles will rely on Beauchamp and Childress’s Principlism, an account of medical ethics which concentrates on the adoption of four basic principles: respect for autonomy, nonmaleficence, beneficence, and justice (2019). Furthermore, this thesis argues for the need to increase educational requirements for all providers as a means of successfully employing Principlism and guaranteeing fat patients the same protections as others. The revised duty of care will establish a framework that challenges HCPs to ground their attitudes about fat patients in scientific research instead of social narratives and ensure the obligations which stem from the duty of care are applied impartially to all patients.