Patient Autonomy

Katie M. Robinson, Jamie Kane, Theodore K. Kyle, W. Scott Butsch

Patient autonomy is fundamental to the ethical practice of medicine.¹ Given the great diversity of patient experiences and goals, not all patients desire treatment for obesity. Additionally, some patients with obesity feel pressure to forgo treatment for a multitude of reasons, including the belief that all weight loss attempts are futile, the implication that obesity is a personal failing rather than a chronic disease, cost associated with treatment, and/or the belief that obesity is a natural bodily variant and to attempt change shows a lack of self-regard. We encourage patients and clinicians to engage in a shared decision-making process to select and pursue optimal obesity care.² Dialogue on the decision to seek obesity care should be respectful of individual values and preferences; as people seeking treatment for obesity already face weight stigma and should not be judged for seeking care.³ Although we respect the right of individuals with obesity to decline treatment, we champion the right of people with obesity to seek care that meets their individual health goals. As we have previously affirmed, every person with obesity should have access to the entire scope of evidence-based care.

1. Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics / Tom L. Beauchamp, James F. Childress. Eighth ed. New York, NY: Oxford University Press, 2019.
2. Charles C, Gafni A, Whelan T. Shared decision-making in the medical encounter: what does it mean? (or it takes at least two to tango). Soc Sci Med. 1997 Mar;44(5):681-92.
3. Rubino F, Puhl RM, Cummings DE, et al. Joint international consensus statement for ending stigma of obesity. Nat Med. Apr 2020;26(4):485-497.