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Ethical Scenario 24
Discuss the ethics of treatment resources being used on patients who knowingly ignore public health advice on smoking and exercise.
The issue here is one of a slippery slope. Many clinicians in the UK have refused to perform non-urgent procedures on smokers, and requested that they quit smoking in order to be eligible for surgery. Their argument centres around smoking causing self-inflicted damage.
However, does that mean we then should not treat over-eaters, under-eaters, alcoholics, steroid abusers, or even someone that injures themselves playing a sport they chose to play? Treating patients shouldn’t involve assignment of blame. People are entitled to make their own lifestyle choices and live without worry of those choices leading to them being refused treatment.
The health professional’s role therefore is not to refuse treatment, but to promote health. One must take every step to alleviate pain and ill health - and this involves advising and educating patients on the effect that smoking or not exercising will have on their health. The British Medical Association advises that clinicians should not make decisions for patients by posing ultimatums to them, as legally they are not permitted to do so.
Everyone should be allowed access to the NHS, whether their injury or ill-health stems from their own behaviour or not.