BMJ  2003;327:104 (12 July), doi:10.1136/bmj.327.7406.104-a

Letter

Smoke free hospitals

Smoke free hospitals are unethical

The first 150 words of the full text of this article appear below.

EDITOR—With reference to the editorial by McKee et al on smoke free hospitals,1 to bar smoking for inpatients with smoking related disease seems reasonable.

To coerce smokers who happen to be in hospital with an unrelated condition into accepting smoke free behaviour as a condition of their care may be questionable.

When patients have no prospect of benefit from smoking cessation, and enforced abstention aggravates their existing distress, they are being managed unethically. Their best interests as a patient (which should be the medical profession's prime concern) are being subjugated to a broader policy that does them harm.

I have been asked by relatives to prescribe nicotine replacement for a terminally ill patient, whose last days in hospital were made worse for nicotine withdrawal. Also one of my patients with extensive stroke related brain damage and end stage peripheral vascular disease declined admission for adequate nursing care and . . . [Full text of this article]

Stephen Head, general practice principal

Middleton Lodge, Newark, Nottinghamshire NG22 9SZ shead@doctors.org.uk


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Relevant Article

Smoke free hospitals
Martin McKee, Anna Gilmore, and Thomas E Novotny
BMJ 2003 326: 941-942. [Extract] [Full Text] [PDF]

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