Death panels UK style

[Gob]

A majority of doctors support measures to deny treatment to smokers and the obese, according to a survey that has sparked a row over the NHS's growing use of "lifestyle rationing".

Some 54% of doctors who took part said the NHS should have the right to withhold non-emergency treatment from patients who do not lose weight or stop smoking. Some medics believe unhealthy behaviour can make procedures less likely to work, and that the service is not obliged to devote scarce resources to them.

However, senior doctors and patient groups have voiced alarm at what they call "blackmailing" of the sick, and denial of their human rights.

Doctors.net.uk, a professional networking site, found that 593 (54%) of the 1,096 doctors who took part in the self-selecting survey answered yes when asked: "Should the NHS be allowed to refuse non-emergency treatments to patients unless they lose weight or stop smoking?"

One doctor said that denying in-vitro fertilisation to childless women who smoked was justified because it was only half as successful for them. Another said the NHS was right to expect an obese patient or alcoholic to change their behaviour before they underwent liver transplant surgery.

Dr Tim Ringrose, Doctors.net.uk's chief executive, said the findings represented a significant shift in doctors' thinking brought on by the NHS in England's need to save £20bn by 2015. "This might appear to be only a slim majority of doctors in favour 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," he said.

Smokers and obese people are already being denied operations such as IVF, breast reconstructions and a new hip or knee in some parts of England. The medical magazine Pulse last month found that 25 of 91 primary care trusts (PCTs) had introduced treatment bans for those groups since April 2011.

Bedfordshire PCT, for example, decided to withhold hip and knee surgery from obese patients until they had slimmed down by 10% or had a body mass index of under 35. Similarly, North Essex PCT obliged obese people to lose 5% of their bodyweight and keep the pounds shed for at least six months before receiving treatment.

But Dr Clare Gerada, chair of the Royal College of General Practitioners, said the survey findings and trend towards "lifestyle rationing" was "very disturbing".


http://www.guardian.co.uk/society/2012/ ... kers-obese

[Scooter]

If the examples cited are indicative of the types of treatment that might be denied, it is completely justified. IVF and transplant procedures are incredibly expensive and have limited success even in the best of circumstances; to offer such treatments to patients who present with a high risk for failure would be ludicrous. Joint replacements are going to be of limited benefit to someone who is grossly overweight, and expecting patients to shed some pounds before getting one is just common sense.

[MajGenl.Meade]

I agree - although I'm pretty sure my weight would rule out a knee replacement in Essex. Perhaps a weight-loss regimen should not be thought of as a "not unless" restriction but as a "part of the procedure" benefit.

Still it does goes give one pause for thought. Perhaps if they banned helping sick people at all the waiting lists would become more reasonable

meade

[Crackpot]

It is sort of hard to lose weight when you can barely walk. A long term knee injury can lead to the avoidance of/inability to excersize. My dad has had both knees and a hip replaced and is in better shape now for just that reason.

THey seem to be putting the cart before the horse on that one.

[MajGenl.Meade]

(Not a knock on your dad but in generally bad taste ...)

A double amputation would solve both problems....?

[Crackpot]

would definately neat the cart then.

[dgs49]

Although this does not happen in the U.S., it certainly happens in the U.S.

My brother-in-law in Michigan is a large, Polish fellow who tips the scales at around 350 lbs. He has what used to be called "big bones," and could probably carry 250lbs and not be "fat."

But he has not been able to find a surgeon willing to give him a needed hip replacement. All have said that he has to lose some weight before they will schedule the operation. One was willing to live with a nominal weight loss (10 lbs), but said that if he was not maintaining that weight he would cancel the surgery. He has zero self control (like me), and cannot seem to get it together enough to satisfy the surgeon, so the surgery is on indefinite hold.

The fundamental question, whether you are talking about private or public insurance, is: Can these decisions be made on the assumption that funding for "healthcare" is infinite? As much as doctors and hospitals complain about MEDICARE and MEDICAID limitations, those two institutions are responsible for more wasted healthcare spending than any other factor. As long as granny has MEDICARE they will bury her with a mountain of tests and procedures until her good heart stops beating - and beyond, if you want to know the truth.

[oldr_n_wsr]

I know if I ever needed a liver or lung transplant, I would not go for it. I have no right to those organs having drank and smoked to the extreme.
Thankfully my latest chest xray showed nothing and my liver is in great shape according to whatever blood tests they did on me in rehab.

[BoSoxGal]

What resources does NHS provide people to assist with smoking cessation and weight loss?

[Scooter]

SmokeFree - NHS will pay for smoking cessation drugs and counselling, along with providing other resources.

NHS Weight Loss Resources - includes weight loss classes (will also pay for memberships in commercial weight loss clubs), diet and exercise advice, weight reduction surgery in extreme cases not responsive to other strategies.