Abstract:
The prevalence of weight loss surgeries has increased worldwide, yet little is known about the process of screening and evaluating patients before surgery. Medical professionals in committees that serve as gatekeepers for bariatric surgeries face daily dilemmas and are compelled to navigate the intricacies of competing demands. This ethnographic inquiry of a multidisciplinary medical committee delves into the nuanced decision-making processes, a complex task even though most surgery applications are approved and subsidized in Israel. Findings show three main frames of justification that professionals’ logics rely on. These frames include 1) adherence to medical protocol grounded in empirically derived data and medical authority, 2) emphasis on patients’ autonomy and responsibility for their lifestyle choices, and 3) the intricate balance within the concept of patients’ benefit. The latter, a somewhat contested notion, encompasses conflicting factors—consideration for patients’ suffering and aspirations for weight loss and improved health, juxtaposed against experts’ clinical knowledge, potentially resulting in decisions misaligned with patient expectations or intensifying their distress. This article contributes to ongoing dialogues surrounding professional evaluation processes and decisions over deservingness, shedding light on the influence of fat stigma and professional ethics on the screening of candidates. Importantly, it underscores that medical dilemmas persist, even in the absence of fiscal constraints, thereby broadening the discourse beyond financial considerations.
