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Subscribe to RSSA majority of doctors in a United Kingdom survey supported measures to deny non-emergency medical services to smokers and the obese, The Observer newspaper reported Sunday.
Although the survey by the networking website doctors.net.uk was a self-selecting poll, the site's chief executive called the response "a tectonic shift" for the profession.
The results feed into a British debate about "lifestyle rationing" by the National Health Service, the Observer reported.
The survey by doctors.net.uk, which claims nearly 192,000 members, found that 593, or 54 percent, of the 1,096 doctors who participated answered yes to this question: "Should the NHS be allowed to refuse non-emergency treatments to patients unless they lose weight or stop smoking?"
Doctors who approved gave a few examples, The Observer said:
- Denying in-vitro fertilization to childless women who smoke was justified because the procedure was only half as successful for them as for non-smokers.
- Obese or alcoholic patients should be expected to change their behaviors before undergoing liver transplant surgery.
Doctors and patients who oppose lifestyle rationing call the approach blackmail that denies the sick their human rights, The Observer said.
Dr. Tim Ringrose, doctors.net.uk's chief executive, told The Observer the findings represent a significant change in doctors' attitudes, considering that the health service must save 20 billion pounds ($32.5 billion) by 2015.
"This might appear to be only a slim majority of doctors in favor of limiting treatment to some patients who fail to look after themselves, but it represents a tectonic shift for a profession that has always sought to provide free healthcare from the cradle to the grave," Ringrose said.
Dr. Clare Gerada, chair of the Royal College of General Practitioners, told The Observer the NHS should deliver care according to need.
“Clearly, giving up smoking is a good thing,” Gerada told The Observer. “But blackmailing people by telling them that they have to give up isn't what doctors should be doing."
Clinical advice about lifestyle changes are another matter, other doctors said.
"Lifestyles contribute to risk and sometimes they may make treatments too risky to undertake,” John Saunders, chair of the Royal College of Physicians ethics committees, told The Observer. “But that's quite different to saying, 'I'm not going to give you surgery because you smoke or are overweight.'"
Some UK private care trusts already ban in-vitro fertilization, breast reconstructions and hip and knee replacements for smokers and the obese, The Observer said.
Dr. Michael Ingram, chair of Red House Clinical Commissioning Group in Hertfordshire, last month wrote in the doctors' website Pulse that "Rationing is dressed up as science."
"Where does this go next? Will we deny IVF to those who have had pelvic inflammatory disease because of its association with sexual promiscuity?" Ingram wrote.
In the United States, debates have been held on withholding liver transplants for alcoholics and coronary artery bypass surgery for smokers, although no ban is in place.
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How many livers has David Crosby drank through?
About 12!
Here's a message to all the UK DOCTORS!
GO SCREW YOURSELVES YOU BUNCH OF REJECTS!
You don't deserve to be in the Medical Profession ! You're ALL DISGUSTING A DISGRACE AND A BLACK MARK ON THE MEDICAL PROFESSION!
Dr Mengela would of loved you,you STUPID CLOWNS!
no we call it triage. we put some things before others, just like a dui crash regardless of severity should be treated after you deal with my hangnail or ingrown hair because stupidity caused your problem... i want to see the day we just let them rot where they are and they get thrown in the garbage!!!!!!!!!!!
Some cardiac surgeons are already telling bypass patients who were smoking prior to having a bypass done, that if they resume smoking and have a recurrence (for those who do continue to smoke it is thought that recurrence will happen 5 to 7 years after the original bypass is done) not to return to them because they will not do the surgery a second time if they are still smoking. Seems reasonable to me.
Dee in Ontario...tried to find the B787tech you mention...hint about where it is date/time? couldn't seem to find it...
I am honest-to-God horrified.
i think service that isn't paid out of pocket should ALWAYS be denied to people that stupid. because if its not paid oop then you owe me money because my premiums etc go up because your a dumb fat lazy retard. we really need this in the usa but we also should be allowed to put them down like a rabid dog because they have proven they aren't smart enough to be allowed to live.
If you look at what acutally kills people, these aren't even in the top 15.
Doctors and the general public have completely lost touch with even basic concepts of health.
If they had anything valid to say, it would be on the topics of the germ transmitted diseases they refuse to treat and dietary issues.
Doctors hold the opinions that their corporate masters tell them to.
Oh, so they can justify denying treatment for any disease that can be linked to lifestyle? That's pretty much everything, isn't it? Gay men have an 18% rate of HIV infection. Clearly we can deny AID's treatment to gay men. No treatment for any STD also. No setting of broken bones for skiers or skaters. Wow, we can save a lot of money this way.
This results of this survey of British doctors should be a wakeup call to all those people who think it's their "right" to get as fat as they want and eat whatever foods they want. I live in an area of the country where practically everyone I see appears to be either already morbidly obese or well on the road to that condition!
Further, the much maligned insurance companies should all be able to put those who fit into this this group into a special category and charge them at a rate which would pay the added expense it actually costs to insure them while those who are healthy and physically active should be recategorized and have their rates cut as a reward for taking their health seriously and for not being a burden to an already over extended health care system!
Obese people and smokers cost the insurance companies less over the course of their lifetime as a percentage of what they pay in. This is because they do not live nearly as long, but do typically live through their productive years when they are paying in to the system. We should be charging the healthy people more, not the unhealthy that will die young.
As a medical doctor it is inappropriate to deny acute care to anyone regardless of whether they are heavy smokers, drug addicts, or fat pigs.
However, I generally refuse to care for such people on a routine basis. The fattys will generally develop diabetes accompanied by poor peripheral circulation, limb loss and renal failure, not to mention blindness plus they have chronic flatulence and generally smell bad. Let the university and county systems care for them. The smokers eventually get their lung cancer, but also may get bladder or laryngeal cancer on the way. An oncologist can give them terminal care. Drug addicts - forget it. They will either O.D., get AIDS or die in sepsis.
Great Britain is on the right track.
Hey, maybe that's a good idea, why should healthy Americans pay the cost of those who smoke and are over weight. Doctors probably already know that they tell patients that smoke or over weight to take control of their health, but these patients refuse and continue their bad habit, so why should doctors waste their time dealing with the unhealthy and just deal with patients who care about their health, makes sense to me. I believe that smokers and obese people should pay a higher premium, they need more care now and in the future.
When a person who smokes has surgery, smoking is a factor in their recovery. Smoking negatively affects the amount of oxygen in the bloodstream - Therefore, it lowers the percentage of cure rates by 50%. So, we are throwing away money on the people who smoke because there is only a 50% chance of their recovering from whatever they were having surgery for. When my sister had a very delicate spinal surgery, her doctor told her that if she continued to smoke, there was only a 50% chance that the surgery would work. She continued to smoke and the surgery was a failure and she had to have discs in her spine fused. Which was not an optimal outcome. She didn't have complete movement in her spine.
So, why would we want to pay insurance/medicare to people who negatively impact their own recovery?
When you say we shouldn't pay for the surgery of the obese, I would hate to be the one who decided where the line should be drawn. However, surgery is very risky for the very obese. And they are right - the obese chose that life.