In City Journal Dalrymple addresses the Lancet’s call for publicly-funded bariatric surgery as a response to the increasing levels of obesity in Britain (as in so many other Western countries). In listing the reasons why personal responsibility in such matters is so often ignored, I think his third item hits on something often seen in discussions of this and similar issues:

Third, and most important, is the false and sentimental belief that, in taxing people with even partial responsibility for their downfall, you must thereby be withdrawing all sympathy from them. To tell a drug addict, for example, that he is not ill but rather is behaving foolishly or badly, is on this view to deny him understanding or assistance. This does not in the least follow, however; though the type of understanding and assistance you will give him will be different from what you would give if you regarded him as solely a victim—say, a dweller of a coastal area devastated by a tsunami.