Should smokers and fat people be denied treatment on the NHS unless they make radical changes to their lifestyle?

[Mrbojangles1]

My objection is not that people smoke or are fat people should do whatever makes them happy as long as they are legal and not inflicting their bad habits on children.

My thing is if these people are not refused treatment and they continue to smoke or over eat their medical condition is very likey to come back or counting thus treating a condition with out change is a waste of money.

Also my oh who works for nhs tells me giving somone who is fat anersetic (sp) is very dangerous the amount to knock them out can often be lethal

Also I think we should be helping people take ownership of their own health

Personally I wouldnt want some one who wouldn't commit to stop somking to have a new heart.

What do you all think
Ps this is not about the wrongs or rights of somking or being aft but about should we expect people to commit to change in order to take up the precious time of surgeons, nurses, doctors and Nhs staff?

On principal I agree with you. I am a smoker but I think if I got to the point of needing a heart transplant my desire to live would overrule my desire to smoke.

However what you're talking about is not in line with a democratic society. We are blessed with the freedom of choice in our country and placing limitations on who is entitled to what depending on how they live their life is a little too close to a nanny state.

If you extend your thinking, do you deny treatment for someone who is run over if they didn't cross at the lights? Should anorexic people be denied treatment if their organs start to fail?

The other thing with organ donation is that it's a two way street. You would deny a smoker a heart transplant, but on their death happily harvest the organs that are useful to give to non smokers with the correct BMI?

Ffs - Addiction is not a disease. It degrades people suffering with real diseases to categorise a lifestyle choice in the same way as a life limiting or threatening disease with real pathology.

Addiction is a disease, some are more predisposed to addiction than others. People don't choose to become addicts ffs

But don't worry we are going to herd up all the smokers/over eaters etc and keep them in the basement until the zombies attack and use them as decoys

I'm sure lots of mners will be happy with that

It's irrelevant how you define it. The point is that we live in a society where we all get to choose how we live our day to day lives. Placing restrictions or withdrawing services from those who make choices that aren't good for their health is akin to telling people how to live their lives... and that's a slippery slope.

And to reiterate... people are either in the organ donation programme or they're not. You take me out as a recipient why the hell should I stay in as a prospective donor? You will end up with even less organs to go around.

They choose to indulge in the behaviour that they become addicted to. It's a problem, NOT a disease.

...

I agree with the organ donation thing. Why on earth should an alcoholic get a new liver when a mother who has always been health concious is dying because she needs one, why should she die and leave her young kids because someone drunk themselves into hat state.

Yes, I KNOW addiction is hard, and life changing and sometimes there isn't a lot of help, but still, people that are looking after themselves should be suffering because of someone who doesn't.

I am going to add the disclaimer here (not that makes a difference) that organ donation is something very close to my heart as my son is likely to need a double lung transplant in the future and the though of a life long smoker getting new lungs over his actually makes me feel sick.

As for non donation issues, I think if we start helping addiction more, and trying to get it in the early stages then the nhs would be saving money, don't leave someone to get to 20+ stone before sending in the dietician, don't let someone be suffering with liver damage due to alcohol before treating it.
I also think that bringing the prices of healthy food down and organising more community exercise classes, and raising the price of junk food right up might help the issue.
Educating people how to cook quick. healthy, cheap meals, is the key.

medical professionals define addiction as a disease, I think they know more about it than you

Lots of illnesses can be bought on by lifestyle choices. Btw there is no hierarchy of disease or illness.

Yes, definitely. Also footballers, skaters, horse riders - especially children. Breaking arms and legs deliberately on a Saturday is just perverse and no doubt deliberate. Wasn't bojangles a dancer? Also prone to deliberate injury. I rest my case.

Doing something thats actually good for you and having an unfortunate accident while doing it is vastly different to deliberately going out of your way to harm yourself.

There is no good reason to smoke and there has been evidence to prove that it causes harm for 50 years now.

It really is defending the indefensible.

OK, yes, we should analyse every part of someone's life and refuse them treatment if they do the wrong thing.

I think we should add people who eat meat every day, people who leave the chicken out of the fridge, people who drive for fun, people who don't look both ways when crossing the road, people who don't wear supportive shoes when walking, people who don't have their 5 a day, people who drink more than 6 or less than 2 cups of coffee a day, or have sugar in tea for a start.

Picking on smoking and being fat is pretty arbitrary - people make choices every day which make them more or less likely to need medical help. Perhaps we should all have a credit score and only people with an A rating get help

I think treatment needs to be given where it can do the most good.

If a treatment is likely to fail or be seriously compromised by a patient's unwillingness or inability to change their lifestyle, then the doctor has to think about whether it's worth spending NHS resources on.

TBH this is a subject close to my heart - members of my extended family are hugely overweight, and are smokers, and have had so much NHS treatment. MIL and FIL (both morbidly obese much of their lives) have had hundreds of thousands of pounds worth of treatment, but haven't changed their lifestyle. BIL has been medically retired at 48 with heart disease but still smokes. SIL is morbidly obese and hypertensive. Sometimes I feel very disheartened by their unwillingness to acknowledge that they are not helping themselves at all.

whisky - you are wrong in the comparisons you make.

There are huge social and health benefits to playing sport.

There are no social, physical or emotional benefits to over-eating or smoking. They are simply damaging behaviours.

It infuriates me when people start to make silly comparisons. A third of smokers will die from their habit. Significantly overweight people over the age of 60 are overwhelmingly prone to serious health problems like cancer and heart disease. It's a massive problem for our society and should do everything we can to help people lead healthier lifestyles, or the NHS is going to collapse under the strain of treating an increasingly unhealthy, ageing population.

Lets not forget....

Alcohol drinkers...not just alcoholics but those who drink over the recommended limit.

Drug users of any type, let's not be discriminatory and include prescription drugs too as they have effects on the body and organs.

Smokers
"fat" people
Anyone who participates in any risky behaviour.....rock climbing, skiing, driving a car, crossing the road....of course any accidents are self inflicted due to their risk taking.
People who sunbathe ( risk of skin cancer)
People who have worked with asbestos etc ( lung disease)
People with a poor diet ( cancers)
Poorly controlled diabetics (loss of limbs, renal complications, eye issues)

The list is endless, perhaps we should chuck an age clause in too and not treat the elderly (age associated disease)

Have a

What about people who work when the doctor has advised they should take it easy, short or long term?

The person may be hard-working and conscientious, and anyway employers demand it. And if they got signed off and claimed sick benefits you'd call them lazy scroungers.

But they've ignored doctor's advice, so their condition getting worse is clearly their own fault.

What do I think? I think YABU. 'Precious' time? That's their job, that they chose, to treat people who are ill - fat, smoking, whatever.

Of course, restricted NHS treatment would lead to the gap being filled by private health care and insurers, which of course charge the earth.

Hence the compensation culture of the US - because you have to find someone rich to sue when you need healthcare. Lawyers love it.

Shame all the money that economy spends taking people to court couldn't be spent, er, on healthcare.

I wonder if we didn't have a health service that was free at point of use whether "some" people might take a bit more care of themselves.

They don't in the US, Alouise. Or in developing countries I've lived in.

I do think steps should be taken to show some commitment to getting well before the NHS coughs up loads of money. So a person should lose weight before a knee operation, for example. Someone smoking should also try to stop once they request help from the NHS for a smoking related illness. And someone drinking to the point of ill health should try to stop, NHS should of course assist these people to stop.

Actually, we need more people to smoke. If they die early, they'll save the pension crisis. The tax from cigarettes would pay for several new, large hospitals every 5 years. The current ratio between what smokers generate in revenue and what they cost the NHS in smoking-related diseases is something like 2.5:1 I think.

The trouble is, very, very few people can in all honesty say that they lead a life that is optimum in terms of lifestyle, diet and nutrition. We are all guilty of something, and even if we're not doing anything right now, we probably did in the past.

Judging people's worthiness of NHS treatment is a very slippery slope to be starting on.

Judging worthiness is already very rife in the NHS, like a person with Downs Syndrome is less likely to receive a transplant.

Addiction and obesity are complex social issues and not always easy for the individual to solve alone. There should be more investment in making lifestyle enhancements/improvement more accessible, affordable and available.

Healthy lifestyles are more achievable for the wealthy and educated and that is why we cannot legislate in the way you suggest as it is too close to genocide for comfort.

'I wonder if we didn't have a health service that was free at point of use whether "some" people might take a bit more care of themselves.'

Like in the US, the world's obesity capital?