When a Texas hospital last month announced that it would stop hiring obese workers, I didn't know whether to applaud or be appalled. Was the Citizens Medical Center in Victoria setting an appropriate, healthful example or was it discriminating against individuals who've made a lifestyle choice that's nobody's business but their own?


Recently, a number of health care systems have prohibited the hiring of smokers, going so far as to test job candidates for tobacco use. And drug tests have been a routine part of every industry's hiring process for decades now.

Is it fair to consider these employment practices together or is it like comparing apples and oranges and — oh, I don't know — kumquats?

Let's all agree that drug users should not be in a job that provides them access to prescription medications. And, working under the influence, they could pose a real danger to patients and fellow staff.

Can you make similar arguments about smokers whose lungs are so weakened they might have trouble helping patients get out of bed or go into a coughing fit in the middle of a medical procedure? Would obese staffers who are challenged just to pull themselves out of their chairs and walk down the corridor likely be able to safely lift patients and move equipment?

Then there's the image thing. Isn't a hospital and its staff supposed to be a model of fitness and health for their community? Can they live up to that if the nurse reeks of cigarette smoke and the doctor has three chins? Or, for that matter, if the CEO is as big as a bus?

Finally, let's not ignore the financial implications. Employees who engage in unhealthful behaviors tend to be less productive, have higher rates of absenteeism, are more often injured on the job and can be more expensive to insure. Doesn't a hospital have every right to protect its bottom line in any legal way it can?

Then again, don't nearly all of us engage in some kind of risky behavior occasionally? We overdo the beer at Sunday's football games. Or fail to keep as fit as would be optimal for our jobs. Some of us climb mountains or jump out of planes or hunt or sail boats or ride ATVs or ski. A little mishap doing any of those things could seriously affect our productivity, couldn't it?

In certain places, some people might insist on the right to carry concealed weapons, even in the workplace. Some might play video games all night and arrive at work exhausted. Some might engage in unprotected sex.

How deeply do we want our bosses to look into our lifestyle choices? When do certain choices stop being our own and, instead, become a matter for human resources? When does the well-being of our patients, our communities, our fellow employees and our organization trump personal liberty?

Is banning obese workers the right thing to do or a further slide down a slippery slope? Should we applaud or be appalled?

I honestly don't know the answers to those questions. What do you think? Email me at bsantamour@healthforum.com.