Posted on 01/06/2007 4:08:26 PM PST by 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.
Remember remember the fifth of November
Gunpowder, treason and plot.
I see no reason why gunpowder, treason
Should ever be forgot...
"Why not just kill everyone over 70?
70? Why not 30? "
70 helps to solve the social security problem. 30 would prevent too much money from being paid in.
This kind of issue goes to heart of conservatism and freedom.
When government controls the provisioning of services like health care and education, then one finds the moral worldview of the political party most closely involved in controlling these services (i.e., usually the Rats) influencing the way government provides these services, from imposing conditions on access to medical services to perverting the educational curriculum to support that party's standing in the minds of students.
In a secular society whose gods are Health and Longevity, doctors arethe high holy priests who determine cannon and doctorine (sorry, couldn't resist).
Very good point.
Banning surgical procedures for smokers is blatant discrimination against the poor, uneducated and persons with addictive personalities all of which tend to be smokers.
"No one said a word when they gave Mickey Mantel a new organ after YEARS of alcohol abuse."
I seem to recall there WAS quite a bit of discussion.
In actual fact, doctors will NOT do transplants for active substance abusers. They will require abstinence for a period.
So you are arguing that for Mickey, the period had been short, and he had gone ahead of others.
I seem to recall the talk was about how he got to the front of the line, because of his celebrity status.
FYI I have a friend on the list for a liver. He has been clean and sober 15 years, too.
Exactly!
But it would be a waste of time.
I would rather simply make the similarly insane assertion that doctors who make mistakes and the patient dies as a result, they should be executed.
Before they kill again.
Additional two words: morbidly fat.
The third rails of polite health discussions. Both infinitely more common and expensive to society.
"Banning surgical procedures for smokers is blatant discrimination against the poor, uneducated and persons with addictive personalities all of which tend to be smokers."
Yes, but the libs would love it all the more. Then they would be able to demogogue the fact that the poor are being discriminated against in the healthcare system.
It's much like the fact that they've created all these laws that put people in jail, and then complain that there are too many people in jail.
What do you do that's "unhealthy" or risk-taking? Just curious.
You must be too young to catch the film reference, but I'm sure there will be a remake at some point.
In the film, in the future after a devastating holocaust, liberals create a sealed city in which everyone lives in an equal manner and anyone who hits 30 is killed in order to maintain population balance and ensure sufficient resources for society.
The hero, Logan, whose job is to round up people who turn 30 and do not willingly turn themselves in, manages to escape from the sealed city and discovers old people outside living in freedom.
Carousel
Mickey Mantle, so unlike Walter Payton.
Payton was offered the option of moving up on the waiting list for organ donors, he declined this offer because it would mean another would die instead of him.
Patience! Patience!
"Cost arguments are made to support the discriminatory non-treatment of smokers".
Yet in my experience junkies who OD and get readmitted with numerous health problems are treated like royalty in Australian hospitals - no cost arguments heard on that one (sound of crickets).
"National Health Care", "HillaryCare", anything run by the government = Socialized Medicine.
Once it is started, you will have nothing to say, and going to your own doctor and paying for yourself will be illegal.
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