437 Weight Loss in Family and Friends- "Libertarian" Paternalism Not Halo Effect-Phenomenon to Be Made Use of for Broader Good

Abstract Aim To demonstrate the real-world inadvertently accrued value of "Liberal Paternalism", while educating their post-surgery patients in presence of their chaperones. Background Allegations of excessive paternalism by surgeons since the 60s have led to a reverse swing culture whereby trust in surgeons has been replaced by the "legally-required " demand for excessive information to be given. This paper refutes both extremes by describing a form of paternalism that surgeon have always practiced for the good of patients and this case their chaperones and family. Method Following the observations of a nurse in a specialist Bariatric clinic, a questionnaire was forwarded to 426 patients’ chaperones from a typically busy, teaching public sector practice, 1 year after their patients had undergone bariatric surgery (Roux-en-Y bypass, sleeve gastrectomy, revision surgery) Results 62% response rate to questionnaires, demonstrating weight losses of between 12-26% from initial weigh-in amongst the chaperones. Conclusions Professionalism in surgery always has and must continue to imply educating patients in a respectful, non-condescending manner. “Nudging” or Libertarian Paternalism has no role in managing obesity as it works by subconsciously forcing large numbers of unknown patients towards choices deemed beneficial, in the UK’s case, by the government’s economists. Ethically effective surgical choices can be made by those who seek our opinion; it is our duty to be trustworthy and liberal in the information we provide. “Liberal Paternalism” implies mutual respect for autonomy through education and this works as the overt objective is directed towards the patient in question.