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Fat or dying: deserving patients and funding priorities

De Beaux has opened an ethical can of worms with his statements that care and surgery for the obese should take funding precedence to palliative care for the dying.

On the one hand, the “little benefit” expensive drugs can offer patients in their final weeks is very loaded and necessarily subjective. Who has the right to decide their pain is less important, and thus worthy of funding, than the morbidly obese?

But that’s the point; of course the health service has to make this decision, and does when it rations resources. 

Spending more on obesity surgery could save lives, and is certainly a more proactive approach to treatment. Yet de Beaux raises another valid point; the public has little sympathy for obese people, even when increasingly these groups overlap. 

There is a pervading belief that obesity is purely self-inflicted, avoidable and represents a lack of self-control. Regardless of the degree to which this is true, it demonstrates the highly emotional nature of decisions pervading to funding. 

The NHS spends a huge amount on elderly and end-of-life care. This group arguably elicits the highest amount of sympathy and feelings of protectiveness. 

Decisions on spending must be taken objectively, with the best outcomes measured and funded, regardless of our biased attitudes. Yet this is easier said than done; we are only human after all, and the government which controls NHS finances will bear public sympathies in mind when rationing up the cash.

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