Letter: A knife-edge

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THERE is a potential downside to publishing lists comparing surgeons' results ("One in 10 heart surgeons investigated", 31 May). In the future, surgeons may be tempted to offer only the best-prognosis patients an operation. To do otherwise would be foolhardy - one's results will be worse; one's competence will be questioned; one's livelihood destroyed; one may even be struck off. The message to surgeons is clear: treat fit people who are least threatened by their disease. Anyone who verges on the obese, who smokes or drinks, who fails to exercise, who chose their parents badly, or who just might one day have an aggressive tumour, may wish to ponder this.

TS O'Brien

London W4