To treat or not?

Share

The suggestion that some patients may be more deserving than others has divided medical and lay opinion for decades. Should smokers be treated equally with non-smokers? Do the obese deserve sympathy or blame? And what of those who ride motorcycles, knowing they are the most dangerous form of transport?

The suggestion that some patients may be more deserving than others has divided medical and lay opinion for decades. Should smokers be treated equally with non-smokers? Do the obese deserve sympathy or blame? And what of those who ride motorcycles, knowing they are the most dangerous form of transport?

In a first attempt to set out the social values that should underlie the delivery of NHS care, the National Institute for Health and Clinical Excellence wisely rules out discrimination against patients who may be judged to have brought their illness upon themselves. Care must be non-judgmental if it is to be humane.

There may be an exception: it suggests, however, that when a patient imperils the success of the treatment by continuing with the behaviour that made them ill in the first place. So the smoker who refuses to give up might, on this ground, be denied heart surgery.

In a health service where cash is finite, there is an ethical requirement to use resources efficiently - and that means not wasting them on a patient unlikely to benefit. When George Best, the footballer, was spotted drinking after his liver transplant he was rightly criticised. But requiring a smoker to give up in order to preserve the fresh blood vessels being stitched to his heart is one thing. Telling a motorcyclist to sell his machine after being put back together by the surgeons is another. Clinical decision-making must not shade into social engineering or doctors will become even more god-like than they already are.

React Now

Latest stories from i100
iJobs Job Widget
iJobs General

Technical Project Manager - Software and Infrastructure - Government Experience

£400 Per Day: Clearwater People Solutions Ltd: Our client based in Central Lon...

Teaching Assistant in secondary school Manchester

£11280 - £14400 per annum: Randstad Education Manchester Secondary: Teaching a...

Primary teaching roles in Ipswich

£21552 - £31588 per annum: Randstad Education Cambridge: Randstad Education re...

Science teachers needed in Norwich

£21000 - £35000 per annum: Randstad Education Cambridge: Science teachers requ...

Day In a Page

Read Next
A homeless person sleeps in the streets  

This is why I am sleeping rough outside the party conferences

Max J Freeman
Strikes were carried out by manned air force and navy aircraft (File photo)  

Syria air strikes: President Assad now has the enemy he always wanted – Islamist terrorism

Kim Sengupta
Secret politics of the weekly shop

The politics of the weekly shop

New app reveals political leanings of food companies
Beam me up, Scottie!

Beam me up, Scottie!

Celebrity Trekkies from Alex Salmond to Barack Obama
Beware Wet Paint: The ICA's latest ambitious exhibition

Beware Wet Paint

The ICA's latest ambitious exhibition
Pink Floyd have produced some of rock's greatest ever album covers

Pink Floyd have produced some of rock's greatest ever album covers

Can 'The Endless River' carry on the tradition?
Sanctuary for the suicidal

Sanctuary for the suicidal

One mother's story of how London charity Maytree helped her son with his depression
A roller-coaster tale from the 'voice of a generation'

Not That Kind of Girl:

A roller-coaster tale from 'voice of a generation' Lena Dunham
London is not bedlam or a cradle of vice. In fact it, as much as anywhere, deserves independence

London is not bedlam or a cradle of vice

In fact it, as much as anywhere, deserves independence
Vivienne Westwood 'didn’t want' relationship with Malcolm McLaren

Vivienne Westwood 'didn’t want' relationship with McLaren

Designer 'felt pressured' into going out with Sex Pistols manager
Jourdan Dunn: Model mother

Model mother

Jordan Dunn became one of the best-paid models in the world
Apple still coolest brand – despite U2 PR disaster

Apple still the coolest brand

Despite PR disaster of free U2 album
Scottish referendum: The Yes vote was the love that dared speak its name, but it was not to be

Despite the result, this is the end of the status quo

Boyd Tonkin on the fall-out from the Scottish referendum
Manolo Blahnik: The high priest of heels talks flats, Englishness, and why he loves Mary Beard

Manolo Blahnik: Flats, Englishness, and Mary Beard

The shoe designer who has been dubbed 'the patron saint of the stiletto'
The Beatles biographer reveals exclusive original manuscripts of some of the best pop songs ever written

Scrambled eggs and LSD

Behind The Beatles' lyrics - thanks to Hunter Davis's original manuscript copies
'Normcore' fashion: Blending in is the new standing out in latest catwalk non-trend

'Normcore': Blending in is the new standing out

Just when fashion was in grave danger of running out of trends, it only went and invented the non-trend. Rebecca Gonsalves investigates
Dance’s new leading ladies fight back: How female vocalists are now writing their own hits

New leading ladies of dance fight back

How female vocalists are now writing their own hits