AUSSIE MDs DENY SURGERY TO SMOKERS 'UNCONSCIONABLE'
TACTIC

Agence France-Presse

MELBOURNE - Australian doctors are in a furor over medical ethics today
after newspaper reports that some surgeons are refusing to operate on smokers.

Surgeons based at some Melbourne hospitals acknowledged they use smoking as
a way of setting priorities for waiting lists for operations. Others said
they tell patients waiting for surgery that they must quit smoking before
the operation.

The Australian Medical Association said it was "unconscionable" for doctors
to deny smokers life-saving treatment.

"It is within our mandate to ration services and smoking is one way to
define the patient population," said Dr. Greg Snell, a respiratory
physician at the Melbourne's Alfred Hospital.

Surgeons at the Austin and Repatriation Medical Centre said they made
similar demands of surgical patients.

"Why should taxpayers pay for it?" asked Dr. Lou Irving, a respiratory
specialist. "It is consuming resources for someone who is contributing to
their own demise," he said.

"I would not give treatment if I felt ongoing smoking would make the risk
of the procedure too great."

The Alfred Hospital requires patients needing lung transplants to be
nicotine and alcohol-free for six months before they become eligible for
surgery. Dr. Michael Sedgley, president of the medical association's
Victoria branch, said it was not the physician's place to take a moral
stand against smoking. "I don't think we as a profession are able to judge
patients," he said.

He said it was "outrageous" that surgeons and doctors at major Melbourne
hospitals demand smokers kick their addiction before they perform surgery
such as lung and heart transplants, lung reduction and artery surgery.

Bruce Barraclough, the president of the Royal Australasian College of
Surgeons, said some surgery, such as lung reduction, was pointless if the
recipient continued to smoke afterward.

Megan-Jane Johnstone, a professor and health ethicist at RMIT University,
said doctors need to be careful they are not denying treatment to suffering
patients and straying into an area of "moral fascism."

"There's a real concern here that we can see moral judgments masquerading
as sound clinical judgments," she said. "If you start denying smokers on
the grounds that they're suffering from a self-inflicted condition, then
where do you draw the line?

"On that kind of logic then we shouldn't be treating athletes and
sportspersons because they are engaged in activities that have a high
probability of injury ... If someone is facing death, what are they
[doctors] going to do? Are they going to say 'No. Sorry,' and walk away?"