The Computer Wore Menace Shoes

College students have a lot on their plates these days – academics, extracurricular activities, jobs, tuition hikes, student loans with double-digit interest rates – but administrators at one university seem to think some students have too much on their dinner plates, too.

Lincoln University, about 50 miles west of Philadelphia, revised its core curriculum in 2005 to institute a health and fitness requirement that must be fulfilled before graduation. That’s all well and good, until you get to the ways students satisfy it: 1) have passed an old physical education class, 2) pass the new “Fitness for Life” class, 3) have passed an approved class at another university or 4) test out by having a BMI less than 30.

There's no word yet if online students can get around the new requirement.

The requirement has students in an uproar now because seniors preparing to graduate are the first class affected by it, and their last chance to meet it will be the spring semester. Lincoln administrators found 16 percent of the senior class has yet to take the course or test out.

Besides stressing out students, the physical fitness requirement is also causing some conflict among school administrators. In faculty meeting minutes from Nov. 3, Dr. Dana Flint notes that the university may be unfairly targeting overweight students and legal counsel should look into it. Dr. James DeBoy countered by saying “morally as a university we have an obligation to notify students that their health might hinder them in their performance as student.”

Moral obligations aside, requiring students to take a course unless they are under a certain BMI is quite possibly a form of discrimination. The Equal Employment Opportunity Commission’s stance is that the Americans with Disabilities Act covers certain kinds of obesity. Violating the ADA usually doesn’t fly.

Besides the potential for breaking federal law, there’s a possibility students who are not obese won’t meet the BMI cutoff to test out, among other problems with the scale. The obese-at-30-BMI isn’t an absolute number for who will have health problems and who won’t. Simply being overweight (25-29.9 BMI) is a risk factor for a slew of medical problems. And is Lincoln going to force underweight students to bulk up until they get in the normal range?

Going back to the moral obligation to tell students their poor health hurts their studies, where is the line drawn? All kinds of common behaviors among college students – binge drinking, unprotected sex, drug use, lack of sleep – are detrimental to health and, by DeBoy’s extension, academic performance, but nobody’s changing the curriculum to reflect it. Does the university’s obligation extend to genetic disease? Eventually, will a student be encouraged to change academic course because he or she has cancer?

A semester before graduation probably wasn’t the time to get upset about a curricular change that took place four years ago. But Lincoln students have a right to be upset. Americans may discriminate on weight as much as race now, and the need for healthier lifestyles and the desire for acceptance are opposing goals, it seems.

It is not, however, up to a university – or anyone -to decide who qualifies for a degree and who does not based on any criteria but academic performance.

A class-action lawsuit filed July 29 in Essex County, N.J., by The Cancer Project calls for a warning label on hot dogs.

The group wants to peg processed meats as a known carcinogen, citing a two-year-old study from the American Institute for Cancer Research that found daily consumption of two ounces of processed meat raised the risk of colorectal cancer 21 percent. The proposed warning label would read something like, “Warning: Consuming hot dogs and other processed meats increases the risk of cancer.”

Keeping with The Cancer Project’s vision, here are some other seemingly innocuous things that should be given warning labels.

A Florida jury found a hospital did not act unreasonably by sending an illegal immigrant with a brain injury back to his country on a chartered flight without telling his family six years ago.

Guatemalan Luis Jimenez, now 37, was working as a day laborer when a drunk driver in a stolen van crashed into the van he was riding in. Jimenez was left a paraplegic, and a brain injury reduced his cognitive ability to that of a fourth-grader.

Jimenez was a patient at Martin Memorial Medical Center in Stuart, Fla., until July 10, 2003. That’s the day he was sent back to Guatemala – with a backing letter from the country’s government and the go-ahead from a state judge – on a chartered plane. He was later released from a Guatemalan hospital and went to live with his 73-year-old mother.

After suffering a brain injury, Luis Jimenez received three years of care before a hospital sent him back to his native Guatemala.

It appears the hospital acted within federal laws, so I’m not sure how the jury could have found against it. Federal laws dictate hospitals receiving Medicare reimbursements must give emergency care to all patients, regardless of ability to pay, and have to administer an acceptable discharge plan once the patient is stablized.

Obviously Martin Memorial provided emergency care to Martin. Its staff did much more than that, if Jimenez was there for three years. The disagreement has been over the adequacy of the hospital’s discharge plan for him.

Jimenez’s cousin, Montejo Gaspar, was named his legal guardian after the wreck, and Gaspar initially supported returning him to Guatemala. Gaspar changed his mind, however, because it was unclear where Jimenez would receive care in that country. He filed an emergency request to stop the judge’s order, but Jimenez was on the charter plane the next day.

Gaspar’s attorney, Bill King, nearly got to the real issue – “state judges cannot authorize what is tantamount to private deportation of undocumented immigrants.” Considering the level of care provided to Jimenez by Martin Memorial, I find it hard to argue it didn’t meet federal requirements for discharge.

King, however, was OK filing a massive lawsuit against the hospital to cover the nearly $1 million for lifetime care of Jimenez in Guatemala, as well as damages for “unlawfully detaining” him and punitive damages to deter other hospitals from doing the same thing. Apparently three years of care above and beyond what other hospitals would have provided amounts to unlawful detention now.

And if this is an immigration issue, why sue the hospital? Nobody else has money. An insurance policy paid $30,000 to Jimenez and three other people injured in the crash. That doesn’t begin to cover past the first hours of care Jimenez received, let alone three years, and he got one-fourth of that, if that much.

The medical center administration had to know it would receive part of its costs back from Medicare, which probably helps explain why Jimenez received care for so long. It’s not fair to say administrators were trying to dump Jimenez’s care on someone else. If Jimenez wanted to go home, a judge and his government approved it, he was stable enough to make the trip, and he would receive care in Guatemala, then there’s no reason the hospital shouldn’t be able to send him back.

Of course, what really needs to happen is for Congress to make some tough decisions on this subject while it’s debating health care reform. What are illegal immigrants entitled to in the U.S. health care system, and for how long? Do they have the same rights as patients who are citizens? Or are hospitals going to have different guidelines for treating citizens and noncitizens?