Age? Gender? BMI?

A hospital in the Lone Star State has decided that not everything should be bigger by regulating potential employees based on their body mass index (BMI).

However, under heavy criticism (yay puns), this hospital in Victoria, Texas, has ended the policy (or, in the very-not-eloquent words of Jezebel, “reverses the terribly dumb no fatties rule”).

The hospital’s CEO justified the policy by saying: “We have the ability as an employer to characterize our process and to have a policy that says what’s best for our business and for our patients.” In other words, it wanted its health workers to have professional personal appearances.

The BMI requirement for this rule is less than 35 (here’s a useful chart). This policy is not illegal in Texas, nor is it illegal in any state besides Michigan (its anti-weight discrimination law was enacted in 1976).

Basically, we have one side saying that obesity is unprofessional in a healthcare environment and another side saying that it isn’t and that if it is, it shouldn’t matter because that would be discrimination.

Is obesity a disability? A disease? A direct result of personal choices? Or an unfortunate condition caused by one’s financial background? Since it is likely a combination of all the above, it becomes complicated (remember the huge debate on whether airlines are obliged to provide two seats for the morbidly obese? That was a polarizing debate). In addition, unlike race, gender, and sexuality, it is controllable to a certain degree*. Being obese also has intrinsic negative health consequences that are not caused by society discrimination.

In my opinion, there is no question that this hospital is discriminating based on weight (the fact that this is technically legal in 49 states still shocks me) and the CEO might had as well admitted that he and the patients did not like looking at fat people.

But to what degree can a hospital require its employees to “look professional?” It certainly can forbid them from cursing or smoking or not wearing uniforms, but can they ban them from face tattoos? Eating fast food in front of the patients? Or smelling bad? How far can hospitals go before it becomes unethical? We also must keep in mind that a mission of all hospitals is to provide the patients the most comfortable environment possible.

If obesity is a result of personal choice, it certainly is not that different from smelling bad, and I am guessing that the CEO holds this view. As a society, we already “look discriminate:” we don’t ever see fat news anchors or obese clothing store clerks, and at this modern era, an obese person being elected as president is quite unimaginable. We “look discriminate,” we just don’t write them down (I can already see it: “The President of the United States of America must be a native-born U.S. citizen, lived in the U.S. for at least fourteen years, an age of at least 35 and BMI of at most 35”). If you have the option of hiring two people with the exact same expertise and one is obese while the other one is not, which one do you hire?

Obesity is not simply a result of personal choice, and this was one reason why the hospital’s discriminatory policy was rightfully under heavy attack. But the question still persists: How much can hospitals demand from their employees to ensure a quality environment for their patients?

*An interesting article Grace wrote about recently that looks at obesity at a different angle in case you missed it.