Medical Profession Legal Issues - Chronic Health Issue Showcase

General practitioners are the front line of the health care system, but a legal grey area remains regarding their exact obligations to patients with chronic conditions.

This was highlighted recently by the case of Luis Almario, a western Sydney man diagnosed with terminal liver cancer as a result of non-alcoholic fatty liver disease.

A trial judge ordered Mr Almario’s GP, who had been treating him since 1997, to pay more than $360,000 in compensation, saying he had an obligation to act to combat the risks associated with his patient’s morbid obesity.

The decision was then overturned by the Court of Appeal, which concluded that the doctor wasn’t required to do any more than tell Mr Almario he needed to lose weight.

Mr Almario was 53 years old, and weighed 140kgs, when he first consulted the GP in 1997. Six years later he was diagnosed with cirrhosis of the liver and liver failure, which was untreatable and irreversible.

The doctor, who had a focus on environmental and nutritional medicine, believed his health problems were due to exposure to toxic chemicals at work, however that was later found not to be the case.

In court it was argued that the GP should have taken Mr Almario’s liver condition more seriously, including referrals for dietary treatment and management plans, along with appropriate specialists to address the health problems caused by his obesity.

It was suggested that the intervention of specialists and potential surgery may well have been required to save Mr Almario from a fatal disease.

But the Court of Appeal found that the doctor neither had the obligation, nor the power, to do anything more than provide the weight loss advice he did.

While the vastly different findings of the two courts illustrate how divided community and legal opinions remain on obesity, Mr Almario’s case highlights the challenges facing both medical professionals and those suffering from chronic health issues such as obesity.