Should the NHS refuse smokers treatment? Watch

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DH3498
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I am currently doing a research project and would like to ask this question:
Should the National Health Service refuse smokers treatment?

Topics could include: Who is classed as a smoker? Who else should be refused treatment? Etc.

I'd like to get arguments and debatable ideas on either side - however controversial they are.

Thank you, and I look forward to any responses.

[I'm new to The Student Room and I'm sorry if this is in the wrong section.]
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TheGrandmaster
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Nope. Not unless they are going to refuse treatment to everyone else with self inflicted illnesses and injuries.
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DH3498
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But as the risks have been thoroughly researched for the effects of smoking, maybe their treatment should be postponed? Or delayed? To ensure all the people with genetic illnesses are treated first?
Thanks for the fast reply.
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PhoenixFortune
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In this scenario, are the smokers being refused treatment full stop, or only for conditions/side effects of their smoking?
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Derfel
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If it's for a smoking related illness and they are still smoking, then yes.
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moonkatt
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only if they get all the tax back they've paid on their ****.
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DH3498
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PhoenixFortune: Only refusal of treatment that is 'known' to be from the smoking. Obiviously this raises more issues about the certainty, however it is know that 90% of all people with lung cancer smoke, so its quite obvious this is a causational link.

Bramz19: Why do you feel this is a silly idea? P.S No this isn't homework, its just a topic that was raised on Radio 4 Medical Matters and I wanted to do additional research into it.
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DH3498
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Yes, what about if someone gets treatment, then refuses to quit; and subsequently needs treatments once again? For the second time should be refused?
Thank you.
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Reflexive
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some random ideas

all this boils down to how much you blame people for their actions. what I would do is look at all the things that cause smoking. we know that people in certain sociodemographic groups are more or less likely to smoke, e.g. people who are in lower socioeconomic circumstances. there are a multitude of factors that affect smoking. at the same time people must be held to some account responsible for their actions. but it would be a cruel system to say that people are entirely to blame for themselves smoking when we know that smoking is socially structured, and also that smoking is something that has been pushed by the power of big tobacco companies. if they never had this power then they would not have been able to push it so much, so there would be less people smoking. therefore, it is harsh for people to have been pushed into smoking (historically), and then deny them treatment in the present. ultimately some kind of balance is needed. The difficulty, which is extremely difficult, is working out to what extent people are to blame for their smoking. I would postulate that the fair way would be to warn someone that if they continue to smoke, they will die, then if they continue to do so they are at least to some degree accountable. I'm still very unneasy about just letting people die though.

That was a messy para but take from it what you will.
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Ladyliesel
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I can see where you’re coming from but it’s a slippery slope. You can’t deny treatment for people who are partly responsible. Where would it end? A person who breaks their arm falling out of a tree should be refused treatment for being there? An anorexic should be denied help after a heart attack because they let themselves fall into that mindset?

I’m a non-smoker by the way and always have been.
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james22
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No, tax from cigarettes more than pays for the cost of treating smokers*, although I am still for higher taxes on cigarettes.

*I don't actually have a source for this, anyone know where to find one?
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Tiger Rag
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(Original post by james22)
No, tax from cigarettes more than pays for the cost of treating smokers*, although I am still for higher taxes on cigarettes.

*I don't actually have a source for this, anyone know where to find one?
http://www.the-tma.org.uk/tma-public...-from-tobacco/ shows the amount of tax paid on tobacco.

http://www.whatdotheyknow.com/reques...ipts_v_cost_of is useful too.

Where do you draw the line? because if you exclude smokers, then you'll have to exclude everyone who takes a risk. So, that means you wouldn't be able to treat anyone.
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DH3498
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(Original post by Reflexive)
some random ideas

all this boils down to how much you blame people for their actions. what I would do is look at all the things that cause smoking. we know that people in certain sociodemographic groups are more or less likely to smoke, e.g. people who are in lower socioeconomic circumstances. there are a multitude of factors that affect smoking. at the same time people must be held to some account responsible for their actions. but it would be a cruel system to say that people are entirely to blame for themselves smoking when we know that smoking is socially structured, and also that smoking is something that has been pushed by the power of big tobacco companies. if they never had this power then they would not have been able to push it so much, so there would be less people smoking. therefore, it is harsh for people to have been pushed into smoking (historically), and then deny them treatment in the present. ultimately some kind of balance is needed. The difficulty, which is extremely difficult, is working out to what extent people are to blame for their smoking. I would postulate that the fair way would be to warn someone that if they continue to smoke, they will die, then if they continue to do so they are at least to some degree accountable. I'm still very unneasy about just letting people die though.

That was a messy para but take from it what you will.
Thank you, the inclusion of the socioeconomic implications on smoking prevalence is a very interesting topic.

Ladyliesel: Definitely; the difficulty is understanding the responsibility of smokers. Surely if we continue to treat smokers, does the act become more acceptable?

And finally, James22, I have also seen that the costs are covered by the taxes placed on cigarettes, however what about all the resources taken away from other people such as: organs and doctor/surgeon time?
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moonkatt
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(Original post by DH3498)
Thank you, the inclusion of the socioeconomic implications on smoking prevalence is a very interesting topic.

Ladyliesel: Definitely; the difficulty is understanding the responsibility of smokers. Surely if we continue to treat smokers, does the act become more acceptable?

And finally, James22, I have also seen that the costs are covered by the taxes placed on cigarettes, however what about all the resources taken away from other people such as: organs and doctor/surgeon time?
Do you honestly think the NHS gives donor organs to smokers? (I'll give you a clue, they don't). If you were to go onto a medical ward at any time of the year looking around you would see probably about three quarters of the patients in there who have been in some part attributable to their disease. Be that a smoker with COPD, a morbidly obese person with type 2 diabetes, a drinker withdrawing and destroying his liver, someone who's had far too many good breakfasts and has now had a heart attack. An awful lot of patients in hospital these days are there partly through lifestyle choices they have made. If we were to start excluding one group then as others have said, we start on a slippery slope of denying everyone treatment and that's not what the NHS is about. Regardless of the fact that a lot of these people have paid in part for their treatment through NI and taxation, smokers and drinkers have probably paid in excess with the amount of tax they pay. If you had paid all your life into a system that promised you treatment regardless of situation and was declined it due to some new legislation would you be happy?
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PicardianSocialist
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(Original post by DH3498)
I am currently doing a research project and would like to ask this question:
Should the National Health Service refuse smokers treatment?

Topics could include: Who is classed as a smoker? Who else should be refused treatment? Etc.

I'd like to get arguments and debatable ideas on either side - however controversial they are.

Thank you, and I look forward to any responses.

[I'm new to The Student Room and I'm sorry if this is in the wrong section.]
So you let me get this straight: Have the state effectively monopolize the healthcare system, crowd out private firms and cartelise the remaining ones sending prices shooting through the roof, and finally begin to systematically deny state healthcare to select groups, either sending them to an early grave or into the arms of the 'private' oligopoly who will then proceed to play them for everything they're worth - I don't love the rich nor hate the poor enough to advocate a policy like that.
The bottom line is that people should be responsible for the effects of their actions, but it's an all or nothing game. Either have healthcare provided on the market and have people bear the burden of their own risk or have it provided by the state and risk a moral hazard.
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DH3498
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(Original post by moonkatt)
Do you honestly think the NHS gives donor organs to smokers? (I'll give you a clue, they don't). If you were to go onto a medical ward at any time of the year looking around you would see probably about three quarters of the patients in there who have been in some part attributable to their disease. Be that a smoker with COPD, a morbidly obese person with type 2 diabetes, a drinker withdrawing and destroying his liver, someone who's had far too many good breakfasts and has now had a heart attack. An awful lot of patients in hospital these days are there partly through lifestyle choices they have made. If we were to start excluding one group then as others have said, we start on a slippery slope of denying everyone treatment and that's not what the NHS is about. Regardless of the fact that a lot of these people have paid in part for their treatment through NI and taxation, smokers and drinkers have probably paid in excess with the amount of tax they pay. If you had paid all your life into a system that promised you treatment regardless of situation and was declined it due to some new legislation would you be happy?
So what happens if a smoker goes into hospital needing a lung transplant because of the damage caused by all the carcinogens in cigarette smoke? Surely if they don't then essentially they are refusing smokers treatment?

But anyway, like you said: a lot of illnesses are down to lifestyle, why do you think smokers are then being singled out? [Slightly off topic - but still interesting]
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moonkatt
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(Original post by DH3498)
So what happens if a smoker goes into hospital needing a lung transplant because of the damage caused by all the carcinogens in cigarette smoke? Surely if they don't then essentially they are refusing smokers treatment?

But anyway, like you said: a lot of illnesses are down to lifestyle, why do you think smokers are then being singled out? [Slightly off topic - but still interesting]
Generally people with cancer do not get transplant organs, regardless of where the cancer is. http://cancerhelp.cancerresearchuk.o...ne-with-cancer

They do however get lung resections, lobectomies and so on to remove the parts of cancerous lung, along with chemo and radiotherapy. So they're not being refused treatment.

Smokers are probably being singled out because it is a habit that only causes harm, however, while it's still a totally legal habit and one that generates such a massive amount of tax revenue I do not see how we should refuse treatment to this group of people over others with poor lifestyle choices, and refusing everyone treatment goes against what the NHS is.
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Maddog Jones
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No. The point of the NHS is universal healthcare that is free at the point of use. Nothing should alienate that core principle - especially not for some petty 'hurr lets teach them a lesson durr'.
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LurkerintheDark
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(Original post by DH3498)
I am currently doing a research project and would like to ask this question:
Should the National Health Service refuse smokers treatment?

Topics could include: Who is classed as a smoker? Who else should be refused treatment? Etc.

I'd like to get arguments and debatable ideas on either side - however controversial they are.

Thank you, and I look forward to any responses.

[I'm new to The Student Room and I'm sorry if this is in the wrong section.]
Erm, the answer to this question is so obvious it's totally banal. Of course smokers should be treated on the NHS, the amount of revenue raised by tobacco taxation dwarfs the amount spent on tending to infirm smokers. It's like asking 'Do you think the sky's blue?'
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DH3498
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Ok so I understand smokers pay a considerate amount in tax whilst buyin cigarettes; however how do we know whether this is going directly back into funding the NHS? It may just be brin spent in another sector by the government?

Secondly, just like young drivers having to pay more for car insurance due to their increased risk of having an accident, maybe the same theory should apply for smokers?

And finally I have done extensive research about the NHS, it's history and philosophies however I know this maybe extreme but: as lifestyles are changing maybe it calls for a change in the NHS and placing more responsibility to the public.

P.S Surely preventing it in the first place is better than how to treat it?
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