Saturday, 22 February 2020

Compassion From Doctors Isn’t A Substitute For Evidence-Based Care

Herma HesseI was reading a conversation online where a fat person was saying that they wanted evidence-based care from their doctors. A man replied that he teaches nurses and that he makes it a point to teach those future nurses to treat “ob*se people” with “compassion and never cruelty.”

This guy is well-meaning, but check again because he is completely missing the point. There’s nothing wrong with compassion, and it’s certainly a step up from how a lot of healthcare professionals treat fat people. But it’s not a substitute for competent, evidence-based healthcare.

Believing that being fat is a health condition that requires treatment is a problem, whether someone has compassion or not. It’s a paternalistic view rooted in weight stigma. It’s how we end up getting bullshit “people first language” instead of (potentially life-saving) evidence-based care. Calling me a “person with fat” doesn’t help me, having a blood pressure cuff that actually fits me and getting a prescription that isn’t “be thinner” does.

We aren’t asking healthcare providers to see us and think “oh, that poor fat person” we’re asking them to see us and think “there’s a larger patient, I will give them the same treatment a smaller patient would get.”

It’s not that compassion is a bad thing, it’s that all too often “compassion” just ends up being a condescending pity for the fatty who they believe smart or willed enough to succeed at diets, rather than realizing that we don’t fail diets, diets fail us. It’s giving us sub-part treatment but, you know, nicely.

The kind of compassion we need from healthcare practitioners is compassion for the issues (which can include health problems) that can come from living in a fatphobic world, compassion for the fact that we may have serious anxiety about visiting a healthcare practitioner because of the horrible experiences we’ve had with fatphobic HCPs. We need compassion in the form of armless chairs and loveseats in the waiting room and medical equipment that is built to accommodate us.

Fat people deserve compassion from HCPs but we deserve more than that. Fat people deserve compassionate ethical, evidence-based healthcare with the goal of supporting our health, not manipulating our body size.

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