Should Smokers Be Refused Surgery?

Science Daily ^ | January 6, 2007 | BMJ-British Medical Journal

[Brilliant]

Last year a primary care trust announced it would take smokers off waiting lists for surgery in an attempt to contain costs. In this week's British Medical Journal, two experts go head to head over whether smokers should be refused surgery.

Denying operations is justified for specific conditions, argues Professor Matthew Peters from the Concord Repatriation General Hospital in Australia.

Professor Peters says that smoking up to the time of any surgery increases cardiac and pulmonary complications, impairs tissue healing, and is associated with more infections.

These effects increase the costs of care and also mean less opportunity to treat other patients, he writes. In healthcare systems with finite resources, preferring non-smokers over smokers for a limited number of procedures will therefore deliver greater clinical benefit to individuals and the community.

He believes that, as long as everything is done to help patients to stop smoking, it is both responsible and ethical to implement a policy that those unwilling or unable to stop should have low priority for, or be excluded from, certain elective procedures.

But Professor Leonard Glantz from Boston University School of Public Health believes it is unacceptable discrimination. "It is astounding that doctors would question whether they should treat smokers," he says.

"Doctors should certainly inform patients that they might reduce their risks of post-surgical complications if they stop smoking before the procedure. But should the price of not following the doctor's advice be the denial of beneficial surgery?"

Cost arguments are made to support the discriminatory non-treatment of smokers. But why focus our cost saving concerns on smokers? Patients are not required to visit fitness clubs, lose 25 pounds, or take drugs to lower blood pressure before surgery. And many non-smokers cost society large sums of money in health care because of activities they choose to take part in.

Discriminating against smokers has become an acceptable norm, he writes. It is shameful for doctors to be willing to treat everybody but smokers in a society that is supposed to be pluralistic and tolerant. Depriving smokers of surgery that would clearly enhance their wellbeing is not just wrong -- it is mean, he concludes.

Note: This story has been adapted from a news release issued by BMJ-British Medical Journal.

[BillyBoy]

>> If we can give medical care for AIDS, to faggots who CHOOSE THEIR lifestyle, then smokers being denied care are clearly being discriminated against. <<

I don't see your point. Smokers "choose their" lifestyle as well. Nobody is born addicted to cigarettes, or has a gun put to their head and told to smoke cigarettes regularly.

[BJungNan]

No, smokers should not be denied surgery. They should be at the head of the line. That is what the high taxes on cigarettes are for.

Every smoker should be suing for full medical treatment by the government for their smoking related disease.

The tax money was collected to offset rising health care costs for smokers. How can smokers then be denied what they paid for with their taxes.

That would be like a driver not being able to use the roads he paid for with his gasonline tax.

This world is so screwed up.

[BJungNan]

Let them get behind the illegal aliens for the "free" health care.

It is not Free health care. They paid high taxes on cigarettes to offset the cost to government for their smoking related illness.

Pay UP!

[Radix]

I just happen to be up and on FR right now.

The additional taxes on cigarettes in my state (Massachusetts) have been used to line the pockets of Insurance Companies, Politicians, TV stations, the makers of insipid public messages, and the proprietors who actually sell cigarettes.

Just another racket which has had so much success that it insures that lots of other incorrect substances and practices are going to incur increased taxes as well.

[Eric Blair 2084]

Why are we paying MSA payments and tobacco excise taxes? I thought it was to cover the added "health care costs".

We're paid in full to society. Let them tax that Big Mac and Budweiser you are consuming. Why should I pay for your habit.

[Eric Blair 2084]

When they came for the employees of the oldest profession in the world, I did not speak out, as I had no interest in purchasing sex.

When they came for the purveyors of what was deemed to be "obscene" or "offensive", I did not speak out, as I was not a fan of entertainers like Lenny Bruce or Howard Stern.

When they came to ban the female mammary gland from TV, I did not speak out, because Brian Boitano told me not to.

When they came for the people who don't wear seatbelts, I did not speak out, as I always wore my seatbelt.

When they came for the marijuana smokers, I did not speak out, as I was not a marijuana smoker.

When they came for the steroid users, I did not speak out, as I was not a steroid user.

When they came for the pornographers, I did not speak out, as I was not a pornographer.

When they came for the gun owners, I did not speak out, as I was not a gun owner.

When they came for the gamblers, I did not speak out, as I was not a gambler.

When they came for the cigarette smokers, I did not speak out, as I was not a smoker.

When they came for the overweight and the obese, I did not speak out, as I was not overweight or obese.

When they came for the drinkers (again), I did not speak out, as I was not a drinker.

Then they came for me...and there was nobody left to speak out.

[traditional1]

"How can smokers then be denied what they paid for with their taxes."

Because the politically-correct Anti-Smoke Nazi's have decided that they should not have to have a waft of cigarette smoke invade their noses, lest they instantly drop dead of cancer. (They have no problem with diesel fumes from busses and trucks pouring over them in traffic, but they are "totally offended" from a cigarette vapor).

Smokers have been declared an under-class by the Smoke-Nazi's, and the trial lawyers have reaped billions on this farce, all at the expense of a targeted class.

Not unlike the coming "fat tax" (on fast food, already begun as "banning transfats" to lay the groundwork for the Class Action Suits against McD's, Burger King, KFC, etc.).

Attacks on particular classes is the heart of the politically-correct socilists: it is the same mentality that says if you make too much money, we'll take it from you to give to some other class who are "offended" that they can't have what you've got. Jealousy and class envy is the root of anti-smoke Nazi's; no more, no less. The hazards of second-hand smoke are far less than other "acceptable" habits, such as AIDS caused by sex deviate behavior, but we protect that activity as a "freedom of choice".

Wake up, people.

[Still Thinking]

So since they're exempted from receiving care, I assume they will be refunded all amounts they paid into the system over the years, with interest. Or are they only undesirable when it comes to living up to their obligations and just fine for taking money from?

[Still Thinking]

No doubt homosexuals are also disqualified from receiving care.

[Still Thinking]

One word: AIDS.

No, no. They didn't say they were going to quit treating smokers for smoking related illnesses, but that they weren't going to treat smokers. So presumably if you're a homosexual, you can't even get your arm set if you break it.

[P-Marlowe]

There is documented evidence that smoking can negatively affect your recovery after surgery, especially in cases of spinal and other orthopedic surgery. For that reason it is reasonable for an insurance company or a doctor to require that a patient stop smoking before having elective surgery.

Is it "discrimination"? You bet. Sometimes you have to discriminate. If the odds of a successful elective surgery are significanly diminished because of smoking, it is not unreasonable to require that a patient quit smoking before undergoing that elective procedure.

[Still Thinking]

I'm suprised smokers even want to have surgery since they obviously don't give a rip about their health.

People who engage in behavior with a risk probably need surgery MORE and may value it more than others. If a mountain climber breaks his leg, would you wonder why he wanted it set?

Second, they paid into the system just like everybody else, and they have the right to claim the benefits just like everyone else even if their desire to do so were irrational. It's too late for you or me to make that judgement once their money has been collected.

[Beckwith]

Should AIDS patients be refused medical care because of their personal habits?

[Liberty Valance]

Kill all the smokers before they all kill themselves.



It's for the children.

[Old Professer]

The trick to splitting wood is knowing where to make the first chisel chink.

[Old Professer]

Actually they only smoke because it annoys people who like to run other people's lives.

[jackieaxe]

Ah communist medical care: Should skiers get an operation? Should motorcycle riders get an operation? Should skin divers get an operation? Should ski mobile drivers get an operation? Should Pizza Eaters get an operation? Should hockey players get an operation? Should old people get an operation to live just a few more years? Should fill in the blank get an operation?

[Still Thinking]

And the question never seems to be "Should a person who enjoys _______ be allowed to buy and pay for insurance under our system". Nobody ever seems to bother screening until it's time to render services.

[Diverdogz]

So, according to you, smokers care little about their own lives, and they want to piss of those that do care about their own lives. You estimate smokers to be even more despicable and miserable than I.