OET Reading Sample 10

OET Reading Sample 10 - Mihiraa

OET Reading Sample 10

Obesity and treatment complications:

Obese individuals who do not try or do not succeed in losing weight should not be offered a wide range of elective surgical procedures, according to an editorial published in The Medical Journal of Australia. The authors acknowledge this would be a controversial, overtly discriminatory approach, but they say it is also evidence-based. Dr. Sarah Johnson and colleagues from St. Mary’s Hospital argue that obese individuals who undergo surgery have substantially higher risks, and poorer surgical outcomes, and therefore consume more healthcare resources than non-obese individuals. Surprisingly, these new concerns are not based on cardiovascular and respiratory risks but on increased surgical complications.

“A randomized study examining weight loss intervention before gastric bypass surgery saw complication rates reduced from 35% in continuing obese individuals to 10% in those who successfully lost weight,” Dr. Johnson said. “Almost 15% of obese patients who undergo joint replacement surgery experience implant failure, compared with 3% of non-obese patients. These results are obviously significant.” She advocates for prioritization to be grounded in solid evidence rather than arbitrary decisions or political influence. According to Johnson, if there were a healthcare system that could fulfill all patients’ immediate needs and desires, there wouldn’t be an issue. However, as she is aware, no country has achieved such a system. Therefore, it becomes necessary to establish priorities based on available resources.

However, not everyone agrees. Professor Mark Thompson, director of the Obesity Research Center, believes this is not an acceptable approach to medical treatment. “You do not arrange patients based on them being more deserving or less deserving. You give treatment based on need and how a person will benefit. It’s the urgency of that need that’s the main factor.” Thompson says lifestyle factors should only affect treatment in very limited circumstances. “If, because of lifestyle factors, treatment is not likely to work or it will be harmful, then obviously it should not proceed. But we don’t take these factors into account in prioritizing; that would be the end of the healthcare system as we know it.” He says if a doctor believes a patient could lose weight and therefore reduce complication rates, they should encourage the patient to lose weight, but you cannot withhold an operation as punishment for not losing weight. “Many people are not able to lose weight easily. It is a complex condition.”

Dr. Michelle Roberts, the representative of the Royal College of Surgeons, agrees that obese individuals need to be treated differently. “You need to take risk into account. The risks of the procedure versus the benefits, and that is affected by the patient’s weight status,” she says. Roberts, a bariatric surgeon, says complications associated with obesity are so significant that she will delay an operation for gastric bypass surgery so a patient can lose weight for a minimum of six months before the operation. “This is not a moral judgment or an ethical judgment. It is a pure clinical judgment for the benefit of a patient’s outcome,” she says.

There is also the heavy burden of financial pressure that must be considered when dealing with a limited health budget. Dr. Jonathan Reynolds, the director of the Health Economics Institute, says that while there should be no blanket ban or refusal of any surgery, the allocation of public health funds needs to be taken into account. “Why should non-obese individuals bear the financial burden of obesity-related complications?” Reynolds says the additional costs of surgical complications should be calculated, and obese individuals who refuse to lose weight before surgery should pay the additional expense if complications occur. “If they lose weight, they should be treated the same as non-obese individuals. If they don’t lose weight, they should pay the difference,” he says. “You’ve got to motivate them to lose weight, and financial accountability can be a great motivator—if they have the means. So their ability to pay should be means-tested.”

The essence of this argument comes down to the question of whether people who are knowingly engaging in behaviors that may be harmful to their health are entitled to healthcare. Surgery is routinely performed on individuals with other chronic conditions, such as diabetes, who are also at risk of increased postoperative complications. If surgery can be denied to obese individuals, or even delayed, should the same treatment, or lack thereof, be given to individuals with poor control of their chronic conditions due to non-compliance with medical advice? Refusing to operate on obese individuals could land us on a very slippery slope, eventually allowing surgeons to choose to operate only on low-risk patients. Perhaps it would be more prudent for physicians to educate their patients about the risks of obesity, as well as other risk factors, prior to surgery and entitle patients to make an informed decision about their healthcare.


1 What possible reason does the writer give for refusing obese individuals the opportunity for surgery?
Ⓐ the negative effects seen in systematic research.
Ⓑ the overall increased costs to the hospital system.
Ⓒ the known impact on the patient’s heart and lungs.
Ⓓ the higher possibility of post-operative complications.

2 In the second paragraph, Dr. Peters says that prioritizing patients:
Ⓐ is unfortunately necessary.
Ⓑ is less expensive in the long run.
Ⓒ should start at the government level.
Ⓓ has been shown to reduce harmful outcomes.

3 In the third paragraph, Professor Thompson says that treatment should be provided:
Ⓐ to all patients based on a system of merit.
Ⓑ according to the necessity of the individual patient.
Ⓒ regardless of a patient’s lifestyle factors.
Ⓓ once a patient has shown a commitment to lifestyle changes.

4 What does Dr. Robert regard as a significant factor when treating an obese individual?
Ⓐ the length of time a patient has refrained from overeating.
Ⓑ providing an unbiased assessment of each individual.
Ⓒ considering the ethical implications of each case.
Ⓓ the patient’s attitude towards weight loss.

5 In the fifth paragraph, Dr. Reynolds says that when considering the financial burden of healthcare:
Ⓐ obese individuals should fund their own operations.
Ⓑ more public funding is needed to help obese individuals lose weight.
Ⓒ making an obese individual pay incentivizes change.
Ⓓ patients who are obese should not be held accountable.

6 In the fifth paragraph, what opinion is highlighted by the phrase ‘bear the financial burden’?
Ⓐ Obese individuals that refuse to lose weight should still have rights.
Ⓑ Non-obese individuals have fewer complications.
Ⓒ The public should not bear the cost of obesity-related healthcare.
Ⓓ Non-obese individuals are less of a burden on public funding.

7 In the final paragraph, the writer argues that treating obese individuals differently:
Ⓐ is fair as other patients haven’t made such poor lifestyle choices.
Ⓑ could in turn lead to poor decisions concerning other patients.
Ⓒ may ultimately cause such patients to avoid having health checks.
Ⓓ may lead surgeons to discriminate against patients with chronic conditions.

8. What does the word ‘it’ refer to in the last paragraph?

Ⓐ The decision-making process for healthcare.
Ⓑ The action of educating patients about obesity risks.
Ⓒ The prudent approach for physicians.
Ⓓ The need for patients to make informed decisions.

OET Reading Sample 10 Answers





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