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    Friday, December 09, 2005

    A Step Too Far: In England, smokers, drinkers, and over-eaters may be denied needed healthcare. Actually, it isn't as bad as that:

    SMOKERS, drinkers and the seriously overweight may be denied medical treatment if their lifestyle makes it ineffective, the Government’s treatment watchdog said yesterday.

    The National Institute for Health and Clinical Excellence (NICE) said that doctors who considered that a particular treatment might not be effective, or cost-effective, because of the lifestyle of the patient, may be entitled to withhold it.

    However, doctors should not discriminate on the ground that a disease was self-inflicted. Even those who had brought their problems on themselves deserved treatment.

    It makes clear, to the delight of campaigners, that discrimination on the ground of age alone is equally unacceptable. However, when a patient’s age affects the chances that a treatment will work, it can be taken into account.


    This makes sense, although there are a lot of people with emphysema who would fall into this category because they still smoke, and it would be cruel to let them struggle for breath rather than treat them with inhalers. On the other hand, maybe they'd quit smoking if faced with the choice. Then again, maybe they'd just lie about their smoking.

    But, there is a caveat in the recommendations. There has to be evidence that a treatment won't work in the face of a continued life-style. Which, as the article points out, may be hard to prove:

    The evidence may be the tricky factor. Few trials have ever sought to include smokers, drinkers or the obese; thus, demonstrating that a particular treatment works less well for them will not always be possible.
     

    posted by Sydney on 12/09/2005 08:17:00 AM 0 comments

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