[Erma Gerd]

I've just been reading some articles about this case, and I can't get my head around it at all.

The article in Australian Doctor on the case also says:

The court heard evidence that Mr Almario, who also suffered diabetes and had a history of alcohol problems, had repeatedly failed to follow health and management advice from his previous doctors. He had previously been referred to a specialist weight control clinic but success in managing his weight was only short term.

The key aspect of the court's judgement was that although Dr Varipatis had raised the possibility of bariatric surgery with Mr Almario, the GP was insufficiently "proactive" in managing the patient.

The judge said: “...I am satisfied that given Mr. Almario's previous failed attempts to lose weight by conservative means, a more dramatic or robust intervention was required, especially because of the knowledge of Dr Varipatis about bariatric surgery. And I find that it was negligent for Dr Varipatis not to have made this referral by about the middle of 1998.”

Justice Campbell added: “[It] was not sufficient simply to make the option known to Mr Almario, for what it’s worth, and then leave him to take it or leave it, which I find Dr Varipatis did. More pro-active involvement was required.”

Granted there probably is more to this than reported, but how pro-active do you expect your GP to be? Is it enough that they run through options, or should they be firmly prodding you towards what they recommend?

[Ally'smum]

I would hope there is more to that story, otherwise I would expect the doctor to win on appeal.

My FIL is obese and no one, not his wife, children, doctor, anyone has been able to do anything about it, because he doesn't want to do anything about it.

I think all the doctor should do is outline the risks, provide further information and recommend a course of action. If the patient doesn't follow up that is no one's fault but their own.

[Saecularis Angel...]

Isn't that sort of "firm prodding" exactly what has women up in arms about obstetric care? Why is this any different?

FWIW, I have no problem with a doctor saying, "These are your options, this is the one I strongly recommend," but it's a very fine line to walk.

[purplekitty]

If you look into the GP's background you can see there is probably a lot more to this story.
He was reprimanded in 2009 for treating a patient with renal disease with high dose IV Vit C.
Conditions were put on his practice.

The decision will still possibly have unfortunate repercussions for medical care.

[ZombieMum]

I think people have a duty of care to themselves and should not expect to be exempt from taking responsibility about their own health.

If his wife did all the shopping and cooked all his food - is he going to sue her too?

[VermithraxPejora...]

I think people have a duty of care to themselves and should not expect to be exempt from taking responsibility about their own health.

And a Dr should be able to refuse to help a patient if they refuse to be active in the their treatment.

[meggs1]

Interesting case. The quote says that the doctor suggested weight loss surgery but the Court did not accept that occurred. The Court found that the doctor did not offer referral to a bariatric surgeon, multidisciplinary obesity clinic or a liver specialist. It's not a question of forcing him to go.

http://www.austlii.edu.au/cgi-bin/sinodisp...p;query=Almario

The Court found that Mr Almario also contributed to his condition by failing to manage his weight and deduced 20% from his award.

[Elemental]

http://www.caselaw.nsw.gov.au/action/pjudg?jgmtid=162435

I think that the appeal will at the very least decrease the payout. The assumption that a gastric band in 2003 would have arrested the plaintiffs liver disease and diabetes presumes both that he would have had no complications from the band and also achieved sustained weight loss - a claim that would be difficult to substantiate given the high rates of band failure in those without the insight to enact behavioural change. The startling claim that had surgery progressed that the diabetes would have been cured I felt most spurious of all, let alone the assumption that obesity is solely a medical condition, for which a patient bears only 20% responsibility, and that the only reasonable solution is WLS. The consequences of this action will be far reaching - if you are obese expect this to be brought up and documented at every visit.

[Old Grey Mare]

If the patient was not satisfied with the treatment he was receiving could he not have just changed doctors?

[Elemental]

He had had multiple previous doctors who had all referred him for multiple weight loss strategies. I think a great deal of the appeal of the doctor he is suing is that the defendant didn't actually stress that his obesity was at the root of all evil.