The other day, the BBC published an article on the fact that many Type 2 diabetes patients in the UK are failing to get essential tests, which could help them control their condition and avoid serious complications. During a Facebook discussion about this, the question came up as to whether fat-shaming (because we know how indissolubly linked fat and Type 2 are in most people’s minds now, despite evidence that it’s not that simple, and we also know doctors are no strangers to fat-hate) might put people off attending clinics.
There was some agreement that a good, respectful, non-shaming relationship with one’s doctor is essential to controlling Type 2. But there were also those who balked at the mention of respect. ‘Respect needs to be earned!‘ declared one contributor – his implication being that it’s earned by weight loss, and that fat patients therefore had no right to expect respectful treatment from their health providers.
I disagree, obviously, but since this is a common assumption – that fat people should lose weight, not just to gain decent medical treatment, but to have any kind of respect from the world in general – I thought I’d look at it further here.
I’m not talking, here, about the deferential ‘respect’ some of us were raised to have for our elders; or the respect you have for someone of admirable achievements, like music or brain surgery. Those are specialized kinds. What I mean is the kind of respect that dictionaries on both sides of the pond equate with the giving of attention; consideration; due regard for the feelings, wishes or rights of others; avoidance of harm or interference. We’re talking basic human decency.
Perhaps you get a clearer idea of why that kind of decency is so essential if you look at its opposite – contempt. What does it look like when someone treats you with contempt? Plenty of fat people can tell you. Constant scrutiny of your body, your clothing choices and the foods you buy and eat; assumptions about your lifestyle, and angry denial and accusations of lying if you don’t fit those assumptions; catcalls in the street; surreptitious photos of your body uploaded online for mockery; being blamed for everything from the state of the economy to global warming – those are are few of the ways contempt for fat people manifests in everyday life.
The medical profession should, you’d think, be slightly more compassionate than this. Even so, there are times when a doctor or other health practitioner’s views on the body size of a patient override more basic considerations. This site recounts a few of those horror stories.
The sad thing is that medical bodies already have their own ethical guidelines, and most of them are common-sense ways of dealing with people that could be applied to most situations in life outside the surgery:
Be polite and considerate.
Treat people as individuals.
Don’t assume you know everything about them.
Respect their privacy.
Listen to them.
Don’t let your own prejudices get in the way of how you treat them.
If you screw up, be honest about it and say sorry.
None of these are particularly big or complex or difficult. I’d have trouble thinking of any situation in which you couldn’t apply them, and any person you couldn’t apply them to. The best teachers would apply them to children. I know a former prison chaplain who’d certainly apply them (while taking the necessary steps to protect himself and others, yes, but even so) to some of society’s most dangerous people. And I also know that good pathologists, and undertakers, would argue that (OK, with a few tweaks) you don’t even have to still be alive to merit this kind of treatment. As I said above: basic human decency, and something from which no human being is exempt.
What, then, is someone saying when they argue that you have to earn this kind of treatment? It may sound extreme, but in mind of what I just said, I believe they’re saying something close to this: that until you’ve done the earning – that is, fulfilled whatever criteria they demand – in their eyes, you don’t yet qualify as human. That’s a profoundly dangerous thing to think about anyone.
That’s why I think our friend in the debate, the guy who thinks we need to ‘earn’ his respect, needs to do some hard thinking. See, in a free society, he has the right not to like fat people, or to agree with what we say. But it’s still his choice as to how to treat us – and it is a choice. Neither he nor anyone else gets to turn round and say we’re somehow to blame for how they choose to treat us. We ‘earn’ respect, if you like, just by existing. As does everyone.
And I’m glad that (as far as I know) he doesn’t work in the medical profession himself. Because while there are doctors out there who take his point of view, we really don’t need any more people like that – in medicine, or in the world in general.