Tuesday, September 12, 2006

Sixth Circuit Obesity Decision

This morning, the Sixth Circuit issued its decision in EEOC v. Watkins Motor Lines, Inc. The EEOC had brought suit on behalf of a worker who claimed he had been fired because of his morbid obesity (he weighed up to 450 pounds). The Sixth Circuit held that the worker did not have a "disability" for purposes of the ADA, because he did not show that his obesity had a "physiological cause" and therefore qualified as a "physiological disorder." Although the EEOC had shown that the worker's weight was more than 100% greater than the norm (sufficient for a diagnosis of morbid obesity under the traditional definition), they failed to show that the weight was "the result of a physiological condition."

This decision seems to me quite confused, though it's a confusing area so I cut the court some slack. What does it mean to say that morbid obesity has a "physiological cause"? All of our behavior has some physiological cause, if only from hormones and brain activity. And there's lots of reason to believe that brain proteins that alter appetite and activity levels, not to mention genetics, are substantial contributors to morbid obesity. More broadly, every fact about our body is by definition physiological. And morbid obesity, being a condition of one's physiology, is by definition a "physiological condition."

So the problem can't be that the worker's morbid obesity had no "physiological cause" or was not a "physiological condition." The problem has to be that he had no physiological "disorder." But what does that mean? The theory of "disorder" can't be a condition that has some identifiable organic etiology, or most "syndrome"-type conditions would be ruled out. We often just don't know what the etiology of a particular condition is, even when doctors diagnose it, recognize that it calls for treatment, and treat it. For it to make any sense, I think "impairment" has to be defined medically -- according to what are the conditions that are the basis for recognized medical (and psychological, since the statute includes both physical and mental impairments) diagnoses. On that score, morbid obesity that meets clinical criteria should always be an "impairment" -- which doesn't mean it will always be a "disability," as the plaintiff will still have to show actual or perceived substantial limitation of a major life activity.

Thanks to How Appealing for the tip.

6 Comments:

Blogger Mortimer Brezny said...

No one doubts whether someone who is born without legs caused it himself. I think the question is whether his biology made him that way like someone with the "no legs" gene or he's a glutton who wants his hedonistic lifestyle subsidized by other taxpayers.

11:38 AM  
Blogger Peter said...

Normally I don't go in for slippery slope arguments, but mortimer's comment practically demands one: do you *really* want to go down the road of subjecting medical diagnosis to a secondary layer of morality-testing? After all, lust "causes" STDs (which in turn cause other potentially disabling conditions), sloth "causes" heart disease, stroke, etc. You see where I'm going.

Regardless, this case presents a particularly poor example of immorality - "hedonist" is about the last thing I would call a 450-lb. truck driver. Caligula or de Sade, he's not. He's a blue-collar dude who can barely move, let alone work - not a voluptuous life by any stretch of the imagination.

9:10 PM  
Blogger robert said...

I think the practical issue is do we want to have half the population defined as being disabled, because that's where we're headed with obesity at the current rate.

What's the legislative history here? I find it hard to believe that the law was intended to protect fat people.

12:15 PM  
Blogger Aggie Dawn said...

The decision is a little nutty, since obesity is obviously in itself a physiological condition. Requiring it to have a further underlying ur-cause that is also "physiological" (i.e. not related to behavior or environment) is not a standard that is applied to any other condition, so they're really pulling this out of thin air.

It's a not-so-subtle attempt to inject personal responsibility into the ADA mix. An understandable impulse, but real judicial activism. And misdirected in this case, IMHO, since a 450 lb man almost certainly has an underlying genetic predisposition to obesity, if not an outright disorder. They'd be on firmer footing if they were discussing a 50 lb overweight man, where "hedonism" would be a more reasonable diagnosis. On the other hand a 50 lb overweight man is less likely to need ADA protection.

7:09 PM  
Blogger Alone said...

That's not exactly what they said, by my reading.

First, they don't say morbid obesity has no physiological cause. They say _his_ obesity did not. The doctor who examined him found almost nothing wring with him EXCEPT he weighted 405.

We can argue what contitutes physiological obesity all day, but it seems to me that there should be at least one other comorbid condition for there to be the pretense of physiological causes (e.g. obesity AND hypothyroidism). Even then association is hardly proof of causation, but it's a start. Here, he's got nothing.

But that's beside the point, because:

As an aside, adn this was not the point of this case, it seems to me he wasn't fired for being obese. In fact, no one thought the obesity, per se, had been a problem. He was fired for not being able to perform his job safely.

He had been obese and working for some time, and they did not walk up and say, "you're outta here." He injured his knee, then worked 50-60 hours a week for a month, and only then took a leave. No one gave him any trouble.

Despite this, and after documenting shortness of breath and obesity, Dr. Lawrence felt he could not do the job safely. (This is perplexing-- was it the SOB that made him unsafe, or the limited range of motion? Because the obesity had not been a new factor.)

His obesity was, in fact, not substantially limiting in his ordinary life (e.g. he had been able to work for years), and so, as per Sutton, the employer "is free to decide that some limiting, but not substantially limiting, impairments make individuals less than ideally suited for a job."

But getting back to the main argument--it seems as though you are making the same error the EEOC does (as pointed out by the 6th circuit) that an ADA impairment can be either physiological obesity and/or morbid obesity. They state clearly that they meant that "a person's obesity, EVEN morbid obesity, must be [physiological]."

Their counterexample is a good one: what about being abnormally tall? Certainly you can't say that's not physiological.

That's the crux, the spirit of the law, and they made it their final point: that the purpose of these statutes is to protect the disabled. If we start redefining disability as related to abnormal characteristics, and not to abnormal pathology, we're sunk.

http://thelastpsychiatrist.com

11:07 PM  
Blogger Chuck said...

Excellent, Your blog on obesity decision is good.
Keep blogging on.

11:38 PM  

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