Ethical Issues in Bariatric Surgery

Adolescent obesity and obesity-related conditions have risen at alarming rates in the United States, positioning childhood obesity as a major public health issue. The consequences of adolescent obesity are far-reaching and often include medical, psychosocial, emotional, and economic burdens. Traditional interventions targeted at diet and behavior modification are largely ineffective in reducing adolescent adiposity. Bariatric surgery, therefore, is gaining recognition as a means to significant and sustained weight loss in the teenage population. Given the innovative nature of this intervention and the lack of robust evidence to support its safety and efficacy in this population, few procedures are being performed on pediatric patients. Surgical weight loss in young patients with severe obesity poses a staid ethical burden to all involved. This article addresses the ethical issues of beneficence and nonmaleficence as they apply to adolescent bariatric surgery. Bariatric surgery for the treatment of severe adolescent obesity is an ethical and effective approach when performed discriminately in centers that can provide expert interprofessional support.

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Ethical issues in the psychosocial assessment of bariatric surgery candidates

Journal of Health Psychology ◽

10.1177/1359105314556160 ◽

2014 ◽

Vol 21 (7) ◽

pp. 1457-1471 ◽

Cited By ~ 8

Author(s):

Codie R Rouleau ◽

Joshua A Rash ◽

Kerry J Mothersill

Keyword(s):

Bariatric Surgery ◽

Ethical Issues ◽

Psychosocial Assessment

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ETHICAL CONSIDERATIONS IN BARIATRIC SURGERY IN A DEVELOPING COUNTRY

Medicine and Pharmacy Reports ◽

10.15386/cjmed-733 ◽

2017 ◽

Vol 90 (3) ◽

pp. 268-272 ◽

Cited By ~ 1

Author(s):

Aida Puia ◽

Ion Cosmin Puia ◽

Paul Gabriel Cristea

Keyword(s):

Bariatric Surgery ◽

Informed Consent ◽

Obesity Surgery ◽

Western Europe ◽

Ethical Issues ◽

Family Relations ◽

Ethics Committees ◽

Surgical Approaches ◽

Laparoscopic Bariatric Surgery ◽

Best Interest

Background and aims. Obesity is the fastest growing health problem worldwide. Ethical issues linked to obesity are numerous and still under debate even in countries with a long history in obesity treatment.Methods. From 2007 to 2015 we performed several types of bariatric surgical approaches on 250 patients with an average body mass index (BMI) of 42. The age range was 12-64 years. No death was recorded. Direct or phone contact was possible with 90% of them during follow-up. Starting from a specific question based approach in ethics we present aspects regarding obesity surgery in Romania. Patients’ safety, informed consent, cost cover, the role of bariatric surgery in children and bariatric surgeons’ training are discussed.Results. Co-morbidities improved or even disappeared in 90% of our patients. Informed consent is a major problem, due to the lack of public knowledge necessary. The private system in Romania offers bariatric surgery at lower prices than Western Europe but is still out of reach for a person with an average income. Lack of maturity and disharmonic family relations raise a series of challenges in assessing the best interest of children and adolescents. Ethics committees, which operate according to well-defined processes, are more and more active in universities and research centers in Romania, checking that methods and performance of scientific studies meet adequate standards.Conclusions. A detailed informed consent, thorough preoperative patient assessment and method selection are mandatory for good results in obesity surgery. Insufficient financial resources combined with the long time necessary to acquire the expertise for laparoscopic bariatric surgery may represent an additional pressure on both physicians and patients.

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Ethical issues in pediatric bariatric surgery

Seminars in Pediatric Surgery ◽

10.1053/j.sempedsurg.2009.04.009 ◽

2009 ◽

Vol 18 (3) ◽

pp. 186-192 ◽

Cited By ~ 35

Author(s):

Donna A. Caniano

Keyword(s):

Bariatric Surgery ◽

Ethical Issues

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Confronting the grey zone after severe brain injury

Emerging Topics in Life Sciences ◽

10.1042/etls20190115 ◽

2019 ◽

Vol 3 (6) ◽

pp. 707-711 ◽

Cited By ~ 1

Author(s):

Andrew Peterson ◽

Adrian M. Owen

Keyword(s):

Brain Injury ◽

Ethical Issues ◽

Vegetative State ◽

Clinical Care ◽

Grey Zone ◽

Severe Brain Injury ◽

New Methods ◽

Legal Decision Making ◽

Technological Developments ◽

The Brain

In recent years, rapid technological developments in the field of neuroimaging have provided several new methods for revealing thoughts, actions and intentions based solely on the pattern of activity that is observed in the brain. In specialized centres, these methods are now being employed routinely to assess residual cognition, detect consciousness and even communicate with some behaviorally non-responsive patients who clinically appear to be comatose or in a vegetative state. In this article, we consider some of the ethical issues raised by these developments and the profound implications they have for clinical care, diagnosis, prognosis and medical-legal decision-making after severe brain injury.

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