Sunday, November 27, 2005

Is this moral ?

It came out this week that some NHS trusts in England are refusing to perform certain types of surgery (such as hip and knee replacements) on overweight patients in an attempt to cut down on costs and reduce waiting lists. The reasoning behind this decision is not a clinical one but essentially a financial one: some surgical procedures are more likely to have to be repeated on overweight patients and this leads to more costs and bigger waiting lists. In these NHS trusts, being overweight is seen as a choice and not as an illness and, as such, patients should not have these operations until they are fit ! Since most overweight people cannot loose weight without exercising and you cannot exercise with a hip or a knee that needs replacing, this just means that overweight people are basically being told "You're doomed!".
As binge eating, bulimia and other eating disorders leading to weight problems are serious illnesses that can't be dealt with running solely on will power, I really don't see why you can't have a knee replacement if you are overweight but you can have a liver transplant if you are an alcoholic (like George Best did) or be treated for lung cancer if you are a smoker (or will this cease to be true in the near future?). Where do you draw the line on what illnesses people bring upon themselves by their behavior through life ? Should a person be denied treatment because their illness is seen as avoidable ? There would a lot to say about stress related illnesses ...

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