Because of financial pressures, denial of joint-replacement surgery to patients with a body-mass index greater than 30 became a policy of UK National Health Service primary-care trusts there in November, 2005. In America obese people are finding similar attitudes among surgeons: some refuse to operate on them at all; some insist they lose weight first.
The Lancet comments: "Denying a service to a consumer may be an appropriate, if hard-nosed, business decision. But medicine is not just any business. Obese patients deserve care, just like their non-obese counterparts."
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The Lancet