Monday, April 5, 2004

Deny smokers surgery, says doctor

Diehard smokers who have been paying up to three times the price for the cigarettes they smoke, just in case they had to cover more medical bills, are now told by some doctors that they should be refused a wide range of elective surgery.

Elective Surgery such as hip replacements, according to a leading thoracic surgeon Matthew Peters, head of thoracic medicine at Sydney's Concord Hospital, accepts his approach is discriminatory.

You bet! It is more like a con as well because people have literally been paying for their additional medical problems for years to the Federal government paying three times the price for what they smoke to cover medical expenses.

A better idea would be to give the money the smokers payed to the Federal Government in taxes to a doctor who will deal with their medical problems.

Perhaps a doctor who wanted the work instead of one who doesn't.

Doctors who refuse the work should also be refused the money and they can just treat people they want to treat, instead of complaining about services to all citizens equally, regardless of their status.

What about the smoke pollution I inhale on my way through the city everyday? Do you think people can avoid that? What about exhaust fumes in the shopping centre car parks etc...

Dr Peters says smokers who have elective surgery are more at risk of wound infection and consume more healthcare resources. As above!

Medical ethicists and the anti-smoking lobby are critical of the approach, saying it unfairly targets the poor and a stronger focus on anti-smoking initiatives would save more money in the long run.

In an article in the Medical Journal of Australia, Dr Peters says persistent smokers "must accept that some risks are simply unacceptable".

Speaking from his Sydney home yesterday, Dr Peters said the risk of wound infection could only be reduced if a smoker quit six weeks before an operation.

A recent study found infection rates reduced from 27 per cent in continuing smokers to zero in those who had quit.

"Wound infection after joint replacement surgery is associated with, delays in hospital discharge, increased time to effective rehabilitation and massively increased cost of hospital care," he said.

But Stephen Leeder, a professor of public health at the University of Sydney, said the idea was "really problematic".

"I think you can advise people to quit, but to make it a condition of medical care is really excessive," Professor Leeder said yesterday.

"In a democratic society we don't mandate behaviours like that."

He said it was important to provide smokers with information and help them to quit.

"But a lot of people have great difficulty quitting, they are not smokers because they want to be, but because they can't help it."

Professor Leeder and Cancer Council of Victoria director David Hill said the policy could also unfairly target disadvantaged people.

A study by Queensland University's School of Public Health said Australians in socially disadvantaged areas suffered almost twice the rates of smoking-related diseases.

Professor Hill said Australia still rated poorly internationally on smoking prevention spending. US states that significantly increased spending on anti-smoking programs saw a fall in dependence.

But Dr Peters said the decision on whether to refuse surgery to a smoker could be weighed up on a case-by-case basis and doctors would be mindful of the impact on more vulnerable patients.

"I would argue it is almost unethical to spend healthcare resources in ignorance of the medical evidence," he said, adding that there were 40,000 joint replacements a year.

British American Tobacco spokesman John Galligan said yesterday smoking contributed $5.3 billion in excise duties.

"I think it's wrong to discriminate against anyone in society," Mr Galligan said, adding that smokers were often made to feel like "pariahs".

"Sometimes smokers feel alienated. At what point do you end? Drinkers? People with high-fat diets?"

But Dr Peters said clinical evidence showed the obese did not have worse recovery rates from elective surgery than the general public.

By The Addicted 5 April 04

BUGS BUNNY: Nah. What's up Doc? Even when smokers have been paying for the risk? Those risks have been acknowledged by past governments, who have increased the price of cigarettes three fold, to cover the additional risks. Didn't anyone inform Dr Peters? And what about environmental smoke?