Texas Tech Gets a Pass to Fire a Medical Resident for Obesity

Quietly but firmly last year, the Texas Supreme Court ruled that it is A-OK for Texas Tech to fire a medical resident for obesity. No need to hear about whether she could do her job. Her “habitus” was a problem, they said. During a long and difficult emergency case, she was breathing heavily and sweated. Most important, severe obesity (Texas Tech called it morbid) is something that doesn’t qualify a person for protection from discrimination – not as a medical condition or anything else.

If you want an eye-opening account of just how brutal this discrimination can be, give a listen to this episode of This Is Uncomfortable.

Derailing a Career in Medicine

Lindsey Niehay had thought she was on track for success. She graduated successfully from the highly regarded medical school at Texas Tech and was ranked fourth among all applicants when she was accepted into their emergency medicine residency program. But not long after she started, the program got a new director who started talking to Niehay about the importance of staying in shape, suggesting that they work out together.

Then a colleague told her about a meeting with the University’s lawyer, in which the director asked how she could fire Niehay without it looking like a case of weight discrimination.

Things unraveled quickly after that. Texas Tech dismissed Niehay from its emergency medicine residency program in April of 2016. The rationale was problems with her performance, which they attributed to her “body habitus.” That’s a delicate way of saying she was too big to do her job.

Physiology or Lifestyle?

Niehay appealed her dismissal as unlawful discrimination for a disability. She had some success with her appeals. But Texas Tech asked the Supreme Court of Texas to throw out her case, arguing that obesity could not qualify as a disabling condition unless it results “from an underlying physiological disorder, rather than lifestyle choices.”

The Texas Supreme Court agreed with Texas Tech and threw out the case, saying:

“A person’s morbid obesity could be her body’s normal and natural response to the person’s lifestyle choices or eating habits.”

Blinded by Prejudice

The prejudice is clear. People with obesity have to prove that they didn’t do it to themselves if they want any protection from discrimination. Two of the court’s ten justices dissented, writing that:

“Niehay undeniably submitted some evidence that she had a disability and that the University dismissed her from its residency program because of that disability.”

The distractions of a judge’s policy preferences and fears of unwise or untenable results can lead them to disregard protections from discrimination that disability laws provide, according to the dissenting judges.

Patty Nece is an attorney, past chair, and member of the Obesity Action Coalition Board of Directors. She tells us that the current situation is unconscionable:

“Weight-based discrimination is a burning human rights issue that our current laws virtually ignore.  Although those with the chronic disease of obesity should be protected by the Americans with Disabilities Act (and similar State provisions), courts have interpreted the ADA in a way that usually leaves people without any protection.”

Doing the Right Thing?

Most Americans believe we should have protection from such discrimination. Texas Tech should not want a free pass to fire a doctor for having obesity. The fact that they sought it and got it tells us a lot about how they might treat patients living with obesity.

Click here for the story from This Is Uncomfortable on Marketplace.

Fire Dance, painting by Paul Gauguin / WikiArt

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April 14, 2024