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By TANYA TAYLOR, medical reporter |
 INTERNATIONAL
STAND-BY ALERT
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DOCTORS are refusing
smokers potentially life-saving surgery until they quit their habit.
Physicians and surgeons at Melbourne's top hospitals told the Herald Sun they
are denying smokers elective treatment such as lung and heart transplants, lung
reduction surgery, artery by-passes and coronary artery grafts.
Alfred Hospital respiratory physician Associate Professor Greg Snell said reasons for the ban were medical and moral.
"There's not enough health dollars to go around," he said.
"It is within our mandate to ration services and smoking is one way to define the patient population.
"It is common practice to not do elective surgery, and certainly some lung operations, on people who smoke."
Austin and Repatriation Medical Centre senior respiratory physician Associate Professor Lou Irving said it was left to each doctor how to deal with smokers.
"Why should taxpayers pay for it? It is consuming resources for someone who is contributing to their own demise.
"We'd be better off putting the money into the prevention and treatment of tobacco addiction."
Prof. Irving said he knew of many vascular and cardiac surgeons who would refuse treatment based on a patient's smoking status.
"My policy is to very strongly discourage smoking and to encourage them to quit because smoking will reduce the effectiveness of the treatment," he said.
"I would not give treatment if I felt ongoing smoking would make the risk of the procedure too great."
Alfred Hospital patient Steve Marwick admitted yesterday that not even multiple injuries from a car accident could stop his craving.
"I know the people at the hospital are right but it's a pretty hard thing to give up," he said after sneaking out to smoke.
Prof. Irving said strong scientific evidence had shown smokers risked complications such as lung infections during operations requiring anesthesia.
Austin policy meant smokers were strictly denied long-term supplemental oxygen to improve blood oxygen levels because it was too dangerous.
Prof. Irving said it disappointed him when patients refused to help themselves in avoiding tobacco-related diseases.
The Alfred's criteria on eligibility for lung transplants require a patient to have been smoke-free at least six months.
It says candidates must have been free of all substance addiction -- including alcohol, tobacco and narcotics -- for six months.
Prof. Snell said many other specialist treatment units, including heart and vascular, had more informal criteria.
Austin director of vascular surgery Andrew Roberts said research had proved smoking was risky in many types of surgery.
He said studies had shown the long-term results of bypass reconstructive surgery in smokers was deplorable. Unless someone risked losing a limb to gangrene or ulcers, he would refuse to perform the operation.
"Most vascular surgeons will not operate because they know the operation is likely to fail."
Royal Australasian College of Surgeons president Bruce Barraclough agreed some surgery was futile for smokers.
"Lung reduction surgery, for example, where the problem has been caused by smoking, well, there's not much point doing something that is life-threatening if the patient continues to smoke," he said.
Director of the Murdoch Childrens Research Institute ethics program Julian Savulescu said singling out smokers was inconsistent. Many illnesses could also be blamed on a patient's lifestyle, such as obesity and heart disease.
"In principle, the idea of making people responsible for their illness by paying for the consequences of their actions is attractive to some," he said. "But in practice it will ultimately lead to selective discrimination."
He said smokers theoretically paid for extra health care costs through tobacco taxes.
Australië en Nieuw-Zeeland staan, naast Canada al langer bekend als rokers-onvriendelijke landen. Hoever extremisme kan gaan en wat de tol is die een land moet betalen voor eenzijdige medische opleidingen wordt nergens duidelijker dan juist in deze landen waar medische ethiek blijkbaar op een laag niveau wordt onderwezen.
Wanneer emoties het gezond verstand gaan overheersen is er iets echt mis in een samenleving. Wanneer deze manier van denken ook in de politiek gaat overheersen (en daar begint het ook in Nederland steeds meer op te lijken) wordt willekeur de norm.
>A new level of insane zealotry!!! Truly unbelievable! Morticians will
>love this news...
>
>_______________________________
>Friday February 9 5:51 PM EST
>
>Smokers Denied Transplants at Australian Hospital
>By Nic Rowan
>
<snip>
>But Professor Megan-Jane Johnstone, a health ethicist at the Royal
>Melbourne Institute of Technology, told Reuters Health that "smoking is
>an addiction, in a cultural climate of fierce publicity and
>indoctrination about the kudos of being a smoker."
The 'kudos of being a smoker'??? I don't know about anyone else, but I
don't expect applause or praise for being a smoker.
This babe doesn't know what the hell she's talking about, except she's severely
downplaying the "cultural climate" against smokers. The word
'indoctrination' isn't quite strong enough; brainwashing and hate-mongering are
closer to the truth. If she's an ethicist (not a doctor), why doesn't she
see that and address it? But then, she's already convinced herself that
smoking is an addiction...talk about indoctrination!
>Johnstone added, "Should we not treat suicide victims or those who
>over-use alcohol? I believe that 50 or 60 years ago doctors prescribed
>smoking as a treatment for stress. Patients arbitrarily being denied
>treatment is ethics masquerading as clinical judgments."
How can anyone treat a suicide? They're not 'victims', they're dead!
It appears that Australian doctors don't swear to the same Hippocratic Oath that
other doctors do.
>Professor Johnstone commented to Reuters Health that "competent
surgeons
>are not ethicists. This is a complex issue and to deal with it
>simplistically is problematic. There needs to be wide consultation,
>including with healthcare consumers."
ALL doctors (surgeons, competent or otherwise, and non-surgeons) swear an
oath to treat sick people .... except in Australia, apparently.
Johnstone would rather spend unnecessary funds and waste everyone's time with
her 'fact-finding' suggestion (probably to make herself feel useful and
important). There's nothing 'complex' about the issue of refusing
treatment to a patient...any patient: If a doctor refuses treatment based
on his/her own personal demons, then their license should be revoked
immediately.
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