Thursday, July 14, 2011

Chief Starving Bear Weight Loss Center

There's been much discussion of late around the subject of whether parents should lose custody of super obese kids?:

Should parents of extremely obese children lose custody for not controlling their kids' weight? A provocative commentary in one of the nation's most distinguished medical journals argues yes, and its authors are joining a quiet chorus of advocates who say the government should be allowed to intervene in extreme cases.

It has happened a few times in the U.S., and the opinion piece in Wednesday's Journal of the American Medical Association says putting children temporarily in foster care is in some cases more ethical than obesity surgery.

Dr. David Ludwig, an obesity specialist at Harvard-affiliated Children's Hospital Boston, said the point isn't to blame parents, but rather to act in children's best interest and get them help that for whatever reason their parents can't provide.

State intervention "ideally will support not just the child but the whole family, with the goal of reuniting child and family as soon as possible. That may require instruction on parenting," said Ludwig, who wrote the article with Lindsey Murtagh, a lawyer and a researcher at Harvard's School of Public Health.

"Despite the discomfort posed by state intervention, it may sometimes be necessary to protect a child," Murtagh said.

At first blush, this might seem like a reasonable proposal. I mean who would be against the government acting in the best interests of children? Problems begin to emerge however once you start looking at what this really would mean. Who exactly gets to decide what is an "extreme" case of childhood obesity? While the Harvard doctors may have a very limited number of very specific cases in mind today, who's to say how this could be interpreted by government officials twenty or thirty years down the road? I don’t think there’s any shortage of people out there who wouldn’t mind doing a little social engineering to ensure that American kids weighed the “right” amount if given the opportunity to exercise such power. Their threshold for allowing the state to step in and remove kids from their parents in order to slim them down might be quite different from what the doctors behind this proposal have in mind.

Don’t think it could ever happen? Consider that our neighbors to north recently had a case where a judge ordered parents to send their kids to day care and public school because he didn’t feel they were getting enough socialization by being homeschooled. Once you expand the state’s power over children at the expense of parental authority in one area, you make it harder and harder to draw lines about what the limits to the state’s authority should be.

Another interesting aspect to this story was the angle that one of the leading opponents of the proposal took:

But University of Pennsylvania bioethicist Art Caplan said he worries that the debate risks putting too much blame on parents. Obese children are victims of advertising, marketing, peer pressure and bullying — things a parent can't control, he said.

"If you're going to change a child's weight, you're going to have to change all of them," Caplan said.

Yumpin’ yiminey. First off, obese children are victims? Perhaps, but certainly not in all cases. Some kids probably do have a genetic disposition toward obesity and can’t do much about it. Others are obese because their parents are too permissive or entirely absent from influencing what their kids eat. And there are probably some kids who are obese because they choose to eat too much food and not exercise enough. No one wants to talk about this, but I think all know one or two examples from childhood or children we know today where this is all too true.

Secondly, parents “can’t control” that their kids are “victims” of advertising and marketing? Let me see if I understand how this works. Little Johnny sees a McDonald’s ad while watching SpongeBob in the morning. Later that day, when his mom is driving him home from baseball practice, he sees the Golden Arches and begs his mom to swing in for a Happy Meal. At this point, if I understand Caplan’s theory correctly, she is powerless to control what happens next. Those McDonald ad geniuses have diabolically created such a strong urge in Little Johnny’s cerebral cortex that his mother now has no choice but to accede to his demands for rich, fried fast-food goodness. She now MUST go to the drive through and open her purse to sate his desires.
If only there was something she could do. Some word or phrase that she could use to avoid having Little Johnny turn into a chubby monkey. Perhaps a two-letter response that might have prevented this tragedy. Sometimes it’s easier to say you’re a victim.