  
Smokers may be denied heart and lung surgery at Australia hospital
Last Updated: 2001-02-09 13:08:57 EST (Reuters Health)
By Nic Rowan
MELBOURNE (Reuters Health) - Surgeons at The Alfred Hospital are demanding that smokers stop the habit before undergoing major heart and lung surgery, according to a report by Australia's daily newspaper The Age and other media services. The smoking ban has raised a storm of controversy in Australia.
Dr. Michael Sedgley, president of the Australian Medical Association's Victorian branch, told Reuters Health that "we can't make blanket statements about people who smoke and how we will or will not treat them. However, as far as heart-lung transplants are concerned, it's blatantly obvious that a smoker will not do as well as someone who doesn't [smoke]."
Dr. Sedgley added that "such judgments must be made for sound medical reasons, not judging somebody for not giving up smoking."
Professor Megan-Jane Johnstone, a health ethicist at the Royal Melbourne Institute of Technology, said to Reuters Health that "smoking is an addiction, in a cultural climate of fierce publicity and indoctrination about the kudos of being a smoker."
"Should we not treat suicide victims or those who over-use alcohol? I believe that fifty or sixty years ago doctors prescribed smoking as a treatment for stress," Johnstone said. "Patients arbitrarily being denied treatment is ethics masquerading as clinical judgments."
In response to the media storm generated by their policy, The Alfred Hospital released a statement Thursday, February 8, in which it said, "The Alfred's selection criteria is consistent with the published policy of the International Society of Heart and Lung Transplantation. These criteria in part relate to lifestyle factors, which will seriously increase the risk of serious post-transplant complications. Smoking is clearly one of these factors."
"The scarcity of organ availability obliges the Hospital to ensure that the best outcome from the 'gift of life' of an organ donation occurs," the statement continued. "Appropriately, at The Alfred, such decisions are made after thorough evaluation and discussion by a large, highly experienced multi-disciplinary team."
Elsewhere, three quarters of Britons believe that lung cancer patients who smoke have as much right to treatment as non-smokers (see Reuters Health report December 28, 2000).
Professor Johnstone commented to Reuters Health that "competent surgeons are not ethicists. This is a complex issue and to deal with it simplistically is problematic. There needs to be wide consultation, including with healthcare consumers."
The Alfred has refused further comment.
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