Patient autonomy and metabolic bariatric surgery: an empirical perspective
Abstract Background Metabolic Bariatric Surgery (MBS) has gained significant popularity over the past decade. Legally and ethically, physicians should obtain the patient’s voluntary and informed consent before proceeding with the surgery. However, the decision to undergo MBS is often influenced by e...
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| Format: | Article |
| Language: | English |
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BMC
2025-02-01
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| Series: | BMC Medical Ethics |
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| Online Access: | https://doi.org/10.1186/s12910-025-01177-6 |
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| author | Shelly Kamin-Friedman Nili Karako-Eyal Galya Hildesheimer |
| author_facet | Shelly Kamin-Friedman Nili Karako-Eyal Galya Hildesheimer |
| author_sort | Shelly Kamin-Friedman |
| collection | DOAJ |
| description | Abstract Background Metabolic Bariatric Surgery (MBS) has gained significant popularity over the past decade. Legally and ethically, physicians should obtain the patient’s voluntary and informed consent before proceeding with the surgery. However, the decision to undergo MBS is often influenced by external factors, prompting questions about their impact on the patient’s ability to choose voluntarily. In addressing this issue, the study focuses on two key questions: first, which factors influence MBS candidates during the decision-making process, and second, whether these influences undermine the candidates' ability to make decisions voluntarily, according to theories of autonomy. Methods The study employed a qualitative methodology, conducting 21 in-depth semi-structured interviews with adults who had undergone bariatric surgery. The conclusions were drawn from an inductive analysis of the interview data conducted using a grounded theory approach, and by applying theories of autonomy to the empirical findings. Results Our study indicates that interviewees were exposed to different external influences, which had diverse effects on the interviewees' decision to undergo MBS. Category 1 influences included intentional attempts to induce people, through arguments and reason, to accept the attitudes advocated by the persuader in support of the surgery. Applying theoretical accounts of autonomy to these influences suggests that they did not compromise the interviewees’ autonomy. Category 2 influences included threats made by a physician or a family member. These influences were found to undermine autonomy. Category 3 influences included emotional manipulation, informational manipulation, and the construction of medical and social norms. Manipulations and norms were experienced differently by different interviewees, and their impact on autonomy varies depending on the theoretical framework applied. Conclusions Acknowledging that the influences exerted on MBS candidates may undermine their ability to make autonomous decisions regarding surgery, we suggest reformulating the duties that apply to medical practitioners with respect to informed consent to MBS. Medical practitioners who discuss the option of MBS with candidates should be aware of the various factors that influence this choice, and actively promote the candidates’ ability to make autonomous decisions. |
| format | Article |
| id | doaj-art-350697b9e2ef45a8820bf51ea60b29a4 |
| institution | Kabale University |
| issn | 1472-6939 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Medical Ethics |
| spelling | doaj-art-350697b9e2ef45a8820bf51ea60b29a42025-02-09T12:53:25ZengBMCBMC Medical Ethics1472-69392025-02-0126111610.1186/s12910-025-01177-6Patient autonomy and metabolic bariatric surgery: an empirical perspectiveShelly Kamin-Friedman0Nili Karako-Eyal1Galya Hildesheimer2The School of Public Health, Faculty of Social Welfare and Health Sciences, University of HaifaThe Haim Striks School of Law, The College of Management Academic StudiesThe Faculty of Law and the Faculty of Health Services Management, Peres Academic CenterAbstract Background Metabolic Bariatric Surgery (MBS) has gained significant popularity over the past decade. Legally and ethically, physicians should obtain the patient’s voluntary and informed consent before proceeding with the surgery. However, the decision to undergo MBS is often influenced by external factors, prompting questions about their impact on the patient’s ability to choose voluntarily. In addressing this issue, the study focuses on two key questions: first, which factors influence MBS candidates during the decision-making process, and second, whether these influences undermine the candidates' ability to make decisions voluntarily, according to theories of autonomy. Methods The study employed a qualitative methodology, conducting 21 in-depth semi-structured interviews with adults who had undergone bariatric surgery. The conclusions were drawn from an inductive analysis of the interview data conducted using a grounded theory approach, and by applying theories of autonomy to the empirical findings. Results Our study indicates that interviewees were exposed to different external influences, which had diverse effects on the interviewees' decision to undergo MBS. Category 1 influences included intentional attempts to induce people, through arguments and reason, to accept the attitudes advocated by the persuader in support of the surgery. Applying theoretical accounts of autonomy to these influences suggests that they did not compromise the interviewees’ autonomy. Category 2 influences included threats made by a physician or a family member. These influences were found to undermine autonomy. Category 3 influences included emotional manipulation, informational manipulation, and the construction of medical and social norms. Manipulations and norms were experienced differently by different interviewees, and their impact on autonomy varies depending on the theoretical framework applied. Conclusions Acknowledging that the influences exerted on MBS candidates may undermine their ability to make autonomous decisions regarding surgery, we suggest reformulating the duties that apply to medical practitioners with respect to informed consent to MBS. Medical practitioners who discuss the option of MBS with candidates should be aware of the various factors that influence this choice, and actively promote the candidates’ ability to make autonomous decisions.https://doi.org/10.1186/s12910-025-01177-6AutonomyNon- controlVoluntaryInformed consentMedical ethicsMetabolic Bariatric Surgery |
| spellingShingle | Shelly Kamin-Friedman Nili Karako-Eyal Galya Hildesheimer Patient autonomy and metabolic bariatric surgery: an empirical perspective BMC Medical Ethics Autonomy Non- control Voluntary Informed consent Medical ethics Metabolic Bariatric Surgery |
| title | Patient autonomy and metabolic bariatric surgery: an empirical perspective |
| title_full | Patient autonomy and metabolic bariatric surgery: an empirical perspective |
| title_fullStr | Patient autonomy and metabolic bariatric surgery: an empirical perspective |
| title_full_unstemmed | Patient autonomy and metabolic bariatric surgery: an empirical perspective |
| title_short | Patient autonomy and metabolic bariatric surgery: an empirical perspective |
| title_sort | patient autonomy and metabolic bariatric surgery an empirical perspective |
| topic | Autonomy Non- control Voluntary Informed consent Medical ethics Metabolic Bariatric Surgery |
| url | https://doi.org/10.1186/s12910-025-01177-6 |
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