ACOG guidance on ethical considerations in care of Obesity patients
American College of Obstetricians and Gynecologists, ACOG has released its guideline on ethical considerations in the care of Obesity patients. This Committee Opinion has been updated from its previous version to focus on obesity bias within the medical community and to provide practical guidance using people-first language instead of labels (ie, “patients with obesity” versus “obese patients”) to help obstetrician-gynaecologists deliver effective, compassionate medical care that meets the needs of patients with obesity.
Obesity is a medical condition that may be associated with bias among health care professionals, and this bias may result in disrespectful or inadequate care of patients with obesity. Obstetrician-gynecologists regularly care for patients with obesity and play an integral role in advocating for best practices in health care and optimizing health outcomes for patients with obesity. Obstetrician-gynaecologists should be prepared to care for their patients with obesity in a nonjudgmental manner, being cognizant of the medical and societal implications of obesity.
Major Recommendations are -
Based on the principles outlined in this Committee Opinion, the American College of Obstetricians and Gynecologists (ACOG) provides the following recommendations and conclusions for the care of patients with obesity:
- Obesity is a medical condition and should be treated as such. Obstetrician-gynecologists should focus on patient-centered counseling regarding the medical risks associated with obesity and on concrete strategies and goals to improve overall health.
- Obstetrician-gynecologists should be mindful of the tendency to harbor implicit bias toward patients with obesity, engage in self-reflection to identify any personal implicit bias and take steps to address any identified bias to help ensure that it does not interfere with the delivery of respectful clinical care for patients with obesity.
- Obstetrician-gynecologists should advocate within their clinics and institutions for the best possible resources to provide optimal care for patients with obesity.
- It is unethical for obstetrician-gynecologists to refuse to accept a patient or decline to continue care that is within their scope of safe practice solely based on an arbitrary body mass index (BMI) cutoff or because the patient has obesity.
- Although obesity is not an indication for the transfer of routine obstetric or gynecologic care, consultation with or referral to physicians with expertise in obesity may be appropriate if the obstetrician-gynecologist cannot safely and effectively care for the patient because of a lack of specialized training, experience, or institutional resources.
- Beginning early in their training, it is important to provide medical trainees with the skills needed to treat patients with obesity effectively and to communicate openly and in an unbiased manner about obesity.
Patient-centred Counseling to Address Obesity
- Encourage Healthy Behaviors Among All Patients
- Focus on Medical Risks and Address Overall Health
- Use People-First Language
- Exhibit Empathy, Sensitivity, and Support
- Use Motivational Interviewing to Encourage Healthy Lifestyle Changes
Safe, effective, and compassionate care of patients with obesity may require special considerations in the clinical setting. Obstetrician–gynecologists should advocate within their clinics and institutions for the best possible resources to provide optimal care for patients with obesity. Although obesity is not an indication for the transfer of routine obstetric or gynecologic care, consultation with or referral to physicians with expertise in obesity may be appropriate if the obstetrician–gynecologist cannot safely and effectively care for the patient because of a lack of specialized training, experience, or institutional resources. Many physicians report they lack the confidence, knowledge, or skill to incorporate evidence-based guidelines for obesity care into their practice. Early and continuing medical education also should include instruction in how to assess, explore, and combat implicit weight bias.
For more details click on the link: www.acog.org