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Comment by klyrs | Hacker News Reader

> Dissection is also made more difficult when a cadaver carries more fat—the dissector has to cut through the layers of fatty tissue to reach the body's organs.

Making this particular accommodation has consequences: surgeons turn fat patients away because they don't know how to operate on them. Surgeons can be quite rude in the delivery of that decision, to the point of fat-shaming. While the policy itself might have short-term bona fide reasons, tables can be made bigger and students could be gaining experience with gantries used to move large patients. The medical industry is making perfect the enemy of good in refusing to care for fat patients, and refusing fat cadavers is just one aspect of that.

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They don't turn them away because "they don't know how to operate on them" they turn them away because many surgical procedures on obese patients are well studied to have negative outcomes and risks for obese patients that do not justify the procedure. There is no polite way to say "you are too obese to undergo this procedure" using a modern framework of body acceptance, and that is a problem with the body acceptance framework, not the limitations of modern medicine.

> There is no polite way to say "you are too obese to undergo this procedure"

There is, actually, and it involves compassion. And then there's what actually happens: I've been in the other room and heard a friend get literally yelled at by a doctor for their body weight, and heard many similar stories second hand. The verbal abuse that patients endure is inexcusable, and highly counterproductive.

They turn away those patients from some operations because it’s more dangerous dm for the patients in operation and recovery. If the danger outweighs the potential benefit, why do the surgery?

It's in part more dangerous in operation because the surgeons have not trained to operate on bodies in that condition. In part, because they refuse to operate on bodies in that condition, living or dead.

This is self-fulfilling. Of course people who are large enough that surgeons chose not to operate on them have worse health outcomes. They will also get fewer interventions that are less invasive, because practitioners won't want to take the risk that the intervention goes bad and the patient needs surgery, because surgeons won't operate.

Of course people who are large enough that every interaction with the medical system involves an irrelevant discussion of weight and diabetes despite a lack of diabetes symptoms will avoid interacting with the medical system, because it's tedious. (sometimes a discussion of weight is relevant, but often times it really isn't)

It’s more dangerous because it takes more time, nurses have to manually hold back hunks of flesh, visceral fat blocks the view of key veins/nerves/arteries, more anesthesia is required, and really everything else. Moreover recovery from surgery is worse and more complicated.

Wouldn't this in turn enable what is, by and large, an avoidable state of self that adds considerable strain on an already overly-taxed medical system?

Placing the burden of reducing strain on a medical system as bad as the USA's is ridiculous. There are reasons to want to avoid obesity but how is one of them to accommodate the medical system? The reasoning is completely backwards. It's like saying that the legal system should not get better at finding who is at fault because it will reduce people's self-reliance at resolving conflicts.

Suppose I break my collar bone riding my bike down a mountain. That's a totally avoidable state of self; people really shouldn't be doing 60mph without adequate protective equipment. Should I be turned away at the hospital?

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