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Monday, March 31st 2008

British Doctors Say Don't Treat The Old And Unhealthy

Lying In A Beach Chair Does A Number On Your Hips

This survey of British physicians was published in a British magazine a while back and I only now picked it up. In it a majority of respondants say that some care, apparently especially some operations, should be limited by patients’ age and lifestyles.

Smokers, heavy drinkers, the obese and the elderly should be barred from receiving some operations, according to doctors, with most saying the health service cannot afford to provide free care to everyone.


About one in 10 hospitals already deny some surgery to obese patients and smokers, with restrictions most common in hospitals battling debt.

Managers defend the policies because of the higher risk of complications on the operating table for unfit patients. But critics believe that patients are being denied care simply to save money.

One in three said that elderly patients should not be given free treatment if it were unlikely to do them good for long. Half thought that smokers should be denied a heart bypass, while a quarter believed that the obese should be denied hip replacements.

Tony Calland, chairman of the BMA’s ethics committee, said it would be “outrageous” to limit care on age grounds. Age Concern called the doctors’ views “disgraceful”.

That’s taking voluntary, transparent rationing to a pretty incredible level. When resources are scarce, as in most of medicine, then lifestyle can play a role in who gets what. I have no problem, along with 94% of British doctors in the survey, in saying an alcoholic who is likely to return to drinking shouldn’t be at the top of the liver transplant list.

Ninety-four per cent said that an alcoholic who refused to stop drinking should not be allowed a liver transplant…

Roger Williams, who carried out the 2002 transplant on the former footballer [George Best,] said doctors could never be sure if an alcoholic would return to drinking, although most would expect a detailed psychological assessment of patients, who would be required to abstain for six months before surgery.

But rationing based on age and some of the other suggestions put up in the survey just elicit a ‘yikes.’ Such transparent, open and flamboyant rationing efforts are inevitable in any limited global budget health care system (i.e. Britain’s socialized NHS).

h/t Grunt Doc