Another issue that arises when attempting to optimize the care of the obese woman is one of justice ( 26 ). Many obese women of lower socioeconomic status do not have access to healthy foods or an ability to exercise in a safe environment (8). These factors affect the prevalence of obesity, and physicians should take such social conditions into account when counseling women regarding their weight and providing education regarding approaches to address it. While incorporating strategies to prevent and treat obesity, physicians also should beware of adhering to specific weight thresholds, because by doing so, there is a risk that an entire category of slightly lower weight women who may have near equal risk will be ignored. Additionally, as obese patients use a higher percentage of health care resources, nonobese patients may bear an unjust burden of total health care costs. The best way of effecting change might be incorporating strategies for all patients to live healthier lives and maintain a normal weight, to the extent possible given limited resources.
Case Study #2: Stand your ground when necessary
As an HR director at a large global company, Carla Santos* was often privy to sensitive information about employees. So, when one of the company’s executives became severely ill, she wasn’t completely surprised when a relative reached out to explain the situation. Unfortunately, however, this put her in a tough position. “I possessed medical information which typically an employer doesn’t have access to,” she explains. “The executive team realized that the family had confided in me and they were very interested in finding out the extent and gravity of the illness,” she says. But she didn’t feel comfortable violating the family’s trust by sharing the information. She knew that keeping quiet might negatively affect how her bosses perceived her, but that was a risk she felt was worth taking.
Additionally, bioethics has been condemned for its lack of diversity in thought, particularly with regards to race. Even as the field has grown to include the areas of public opinion, policymaking, and medical decisions, little to no academic writing has been authored concerning the intersection between race- especially the cultural values imbued in that construct- and bioethical literature. John Hoberman illustrates this in a 2016 critique, in which he points out that bioethicists have been traditionally resistant to expanding their discourse to include sociological and historically relevant applications.  Central to this is the notion of white normativity , which establishes the dominance of white hegemonic structures in bioethical academia  and tends to reinforce existing biases.