Should lifestyle discrimination be legal ? With the rising cost of healthcare, companies are looking for ways to save money. Across the US, many companies, including hospitals, are refusing to hire employees who's lifestyle is deemed to be high risk.
Users of tobacco, though perfectly legal, are being told that they aren't entitled to have a job because they smoke or chew tobacco. And many supporters of this new type of discrimination are living very high risk lifestyles themselves. Although they may not yet be aware, companies know when they've stumbled on to something that increases their profits. Eventually, many other groups will be added to the list of unacceptable lifestyles, including those who are over-weight, drink alcohol, poor eating habits, etc. And with advancements in genetic testing and lifestyle screening, the practice of refusing to hire, refusing to insure, or denying many of the opportunities that were once equally available to all, might very well be the way of things to come in America.
How bad does the discrimination have to get before people will begin to recognize it for what it truly is, and take action to stop it?
Do I think religion can be changed? This is where we acknowledge that as an atheist, I am not the right person to ask for a personal opinion on that matter. Religion is a legally protected class. To my understanding, religion is not considered a malleable personality characteristic, but something sacrosanct. Rationally, I cannot even begin to grasp that concept, but I accept it for what it is. But that was not a serious question in the first place, was it?
Obesity is not a legally protected class, nor should it be. There have been legions of studies supporting the hypothesis that more attractive candidates are hired and promoted faster and earn more money than less attractive candidates. Since obesity is not considered an attractive physical attribute in our culture, it stands to reason obese people would suffer the same unfortunate bias as other applicants deemed less attractive. This is neither new nor surprising. The interesting point is that if obesity is the only or the major disadvantage a candidate is facing, it is so easily addressed that it could be a non-issue for many within just a few months time.
A lof less time than it would take to convert to a new Religion or go through gender reassignment surgery.
Obesity is not easily changed. It is well known that the only successful weigh for most people to lose weight is surgical procedures such as gastric bypass, lap band and more recently sleeve gastrectomy. I've read something like 90% of people who lose weight thru diet and exercise regain the weight! It is now being classified as a disease, but I don't think even that will end the discrimination which is endemic in the culture. What is sad is that a majority of people are now overweight or obese and the last I heard the goal is to prevent obesity because once it happens the odds are you'll be obese the rest of your life. Of course it is going to have tragic consequences for your life and limit your potential because of the discrimination. It is harder to get a job etc because you cannot hide the weight. Your comments minimize and trivialize people struggling with obesity and is sad because I'm sure your patients will sense your disdain or do you limit your patients to only fit and trim!
If only obesity was an easily modifiable thing do you really believe people would stay fat when they could be slender and more attractive and socially acceptable and rid themselves of not just the excess weight but the discrimination and disapproval they face on almost a daily basis!
BlueDevil, I'm not talking about obesity being a protected class. And yes, bias will always exist and the law cannot change that. Often, discrimination is unconscious, anyway.
I'm simply saying that to put in place a policy that specifically prohibits fat people from working as NURSES with the assertions that 1) it is setting a poor example for patients, and 2) they cost more in healthcare and therefore more to insure, is a ludicrous a crappy idea.
Do you really think that obesity is a problem "so easily addressed?" Are you kidding? Would it be a nationwide epidemic if it were? Would we even be having this discussion? Sheesh.
Michael, do you think that private entities should be only able to hire white people? Or only men? Or fire anyone over the age of 40? Gee, free markets sort themselves out. It's all so simple now!
Obesity is already a national and even worldwide epidemic! Interesting they are finding so many things contributing to it beyond simply overeating from the BPA in plastics, pesiticides and environmental chemicals to the type of gut bacteria. Not to mention food additives such as high fructose corn syrup that are contributing to weight gain as well. Also it is well known that antibiotics have already been used since the 1950's to fatten pigs, chickens, and cows. How far a stretch is it that it is fattening us too! Don't forget the growth hormones being used in dairy production!
Nurses will be phased out with pcts, that's what my instructor used to tell me. If companies are looking for perfection then robots might be the solution among imperfect mortals.
Robots ala stepford nurses at your service! We aim to please and raise the Press Ganey scores with our exceptional care! lol Also the patients get to choose blonde, brunette or redhead!
The problem is employers are expected to pay the majority for employees health insurance in the US. That system is what is fueling the discrimination. Is it right, no? But I understand it from a business perspective.
While I think all of you make good points the case I am making is simply this. Technology is being exploited to discriminate against the legal activities of citizens in their off work time. In this case, its medical technology. And those of you who think that you are safe from this technology are sadly mistaken. perhaps not you, but sooner or later it will be someone close to you, someone you care about who can't get hired because there are test available to tell if they have smoked even once in the last 90 days, or their cholesterol is too high, or obese, etc... you can call that a slippery slope if you like, but history has proven one thing, if the technology exist, someone will find a way to exploit that technology. The most foolish concept I have every heard of is that you can lower the cost of healthcare by excluding the unhealthy portion of the people from participating. Yet that is exactly the goal of every health insurance company. No one seems to take notice of the average surgeon who earns $600,000 a year, they truly believe that health care cost so much because people aren't treating their bodies like a freaking holy temple. I've got news for all of you, there has never been a shred of proof that a smoker who dies at 60 years old will cost healthcare more dollars than someone who slowly dies at 90 years old. 30 years worth of medications and doctor visits really adds up ya know! Do you have any idea how much it cost to keep that 90 year old person in a retirement home for 15 years with round the clock care? I mean, why in the heck are we not refusing to hire people who ride motorcycles? Why? because there isn't any true logic involved. It's simply a scam for quick profits, a scam, a fictitious story that the insurance companies knew all of the non smokers in America would believe. Give them someone to to blame, while the real crooks rob them blind.[/quote']
You are missing the point that other posters made. It doesnt necessarily leads to a slippery slope effect, and besides like others have expressed is not a matter of discrimination against smoker, it is an image issue ( people who smoke , will smell like smoke the whole day, patients will smell it, families of patients will smell it, everybody will smell it in your clothes , breath, etc) The hospital is gonna want to give the image that it has role-models for their patients as part of their staff ( again an obese person talking about nutrition and balanced diet will never be taken seriously, an smoker talking about quitting while still smelling like he just went outside to puff one) It is a matter of being a role model of what you are meant to advocate, does it means we all need to look like supermodels or be vice free, of course not. It just mean to make changes in our own choices so we can be an example to those we are meant to help, without the obvious hypocrisy of "Do as I said and not as I do" . Perhaps is time to cut on the snacks and exercise, and to change the cigarette for one of those smoke free thingies, you don't have to quit altogether but for everybody's sake, don't smell like cigarette.
As a final note, smoker tend to cost more to employers in health insurance premiums and in productivity ( the employee goes out on work time to get a puff).
And finally you mention discrimination in getting insured, this is called assessing for risk in the actuarial world, and it means that you are a risk to insure because you are more likely to need the money once you are insured. The ACA made sure the discrimination for not insuring risky persons disappeared, but the risk is gonna be there and insurers will put higher premium in those that are riskier.
The slippery slope effect is not a valid argument since there is no proof that screening for smokers will lead to those other effects you describe.
Let's not stop here- what about babies born premature or diabetic- a lifestyle choice of the baby? What if the lifestyle choice of the mother may have caused the diabetes? People with mental illness- 'weak minded'? What about any genetic traits. Where does it stop?[/quote']
There is no evidence a slippery slope effect will occur. It is only an assumption that one thing will lead to all that. Therefore the argument cannot hold itself and fails. This slippery slope effect is the same that anti legalization of marijuana groups use and it has been deemed to be flawed. There should not be discrimination to ones choices in their own time, but if you bring those choices to work and it affects others ( the smell of smoke for example) then you can be held responsible for them.
Also i see that most say that by choosing fit people over obese ones we are choosing attractive people only and thats discriminatory. There is a difference between being fit and being physically attractive. Being fit is a health trait that healthcare professionals should advocate for and hopefully apply to themselves, the hospitals choose to show a public image that they are aligning with their mission, so therefore staff that better represents those health traits they want on patients.
Also i see that most say that by choosing fit people over obese ones we are choosing attractive people only and thats discriminatory. There is a difference between being fit and being physically attractive. Being fit is a health trait that healthcare professionals should advocate for and hopefully apply to themselves, the hospitals choose to show a public image that they are aligning with their mission, so therefore staff that better represents those health traits they want on patients.
Assuming that this is true, that "fitness" and not attractiveness is what matters and therefore is not discrimination, answer me this:
-To what degree to humans have control over their fitness level? To what degree are other factors involved?
-Do you think all obese people are unfit? Do you think all thin people are fit? If you can't tell someone's fitness level just by looking at him or her, should we give healthcare employees fitness tests? Maybe publish the results on our nametags to give us credibility when we are "educating" our patients on diet and exercise?
-So are you saying that a fat person should always get counseled on healthy eating and exercise habits. If those tips are coming from a fat healthcare worker, the patient will dismiss the info because it is obviously hypocritical? This is only true if you assume that people who eat healthy and exercise are thin. That is an incorrect assumption.
Let's try a few scenarios.
Scenario 1: Happening right now in a doctor's office near you!
NURSE: You BMI is in the obese range. That puts you at an increased risk for blah blah blahhh. You need to lose weight. Here is what you should eat. Here is what you shouldn't eat. Here are exercises you need to do. If you don't lose weight, try harder. Your health depends on it!
FAT PATIENT: I've tried x bazillion diets and I never lose weight. I've given up. I may as well be fat and eat what I want than fat and starving. And I hate exercise.
NURSE: Well, think about your health. If it's really important to you, you will try harder.
FAT PATIENT: OK (Leaves fealing demoralized, shamed, guilty, and like a failure. Goes to store to buy some Special K. Goes to gym for a week, hating every minute. Loses no weight. Gives up again).
Scenario 2:
NURSE: Your lab tests show that your cholesterol levels are elevated and your blood pressure is on the high side. Here are some things you can do to help bring your levels within a healthier range.
FAT PATIENT: I have dieted many times before and even when I lose weight, I always gain it back. I hate exercising.
NURSE: Let's focus on behaviors that can help you become healthier. Let's forget about your weight. Even if you never lose a pound, you are improving your odds for good health tremendously. And you don't necessarily need to go to the gym. 30 minutes of moderate activity, 3 days a week has been shown to have a dramatic impact on health. Just try to move your body in ways you enjoy. Eat plenty of whole foods, fresh fruit and vegetables. Listen to your body's cues about hunger and satiety.
Get enough sleep, and try to reduce stress. Of course, once you stop obsessing about your weight and failure to lose it, your stress level will improve!
FAT PATIENT: So are you saying I can be healthy even if I am fat?
NURSE: Yes! That is exactly what I am saying!
FAT PATIENT: Leaves with a sense of hope. Goes to store and buys fruits and vegetables. Makes a point to dance in her living room at least every other day. Freed of feelings of failure, feels much less stressed out. Enjoys life again. Cholesterol falls. BP falls. Stays fat.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
-Do you think all obese people are unfit? Do you think all thin people are fit? If you can't tell someone's fitness level just by looking at him or her, should we give healthcare employees fitness tests? Maybe publish the results on our nametags to give us credibility when we are "educating" our patients on diet and exercise?
-So are you saying that a fat person should always get counseled on healthy eating and exercise habits. If those tips are coming from a fat healthcare worker, the patient will dismiss the info because it is obviously hypocritical? This is only true if you assume that people who eat healthy and exercise are thin. That is an incorrect assumption.
I'm fat. Before my cancer and subsequent treatment, I could swim in the channel behind our house, dodging speedboats, crabbers, jetskis and fighting jelly fish and swell for over an hour each day. I could walk 8 miles, enjoying every yard of it. One might say I was reasonably fit. I was following a Weight Watcher's diet religiously and working out over 2 hours a day most days. I was still fat.
My skinny friend eats chocolate and french fries all day long and doesn't exercise beyond going through the grocery store with a shopping cart. She can't keep up with me for one block, much less eight miles, and won't even try swimming because swimming outside with fish and all is "yukky" and swimming in a nice, sterile pool is "boring." She can't really do any exercise -- and she smokes. She is not fit. But she is skinny.
So I'm a hypocrite if I counsel a patient on diet and/or exercise, but my friend is not?
The trouble with judging fitness by looks is that one is often wrong. But please don't give anyone in management the idea of fitness-testing nurses and putting the results on our nametags. Someone might actually try it!
Ruby, The fitness test suggestion was a sarcastic one. :) There are a whole boatload of problems with that; ableism comes to mind. Why not have job qualification be about your ability to perform your job functions, and not other random factors. And that, my friends, is what this entire thread is about. Selecting employees based on BMI is just as assinine as giving them fitness tests!
smartnurse1982
1,775 Posts
Well,i have already been discriminated against due to my personality. Its not a lifestyle choice.
Nobody likes quiet,shy nurses it seems.
Apparently,its something i am born with and cannot change.
Come to think of it,several nursing applications now have personality tests.