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LETTERS: Stephen Head Smoke free hospitals: Smoke free hospitals are unethical BMJ 2003; 327: 104-a [Full text]

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Duty of care to others.

Raymond Mc Conville   (11 July 2003)

Banning smoking is not unethical

Martin McKee   (12 July 2003)

Arrogance

Burt L. Jackson   (14 July 2003)

Duty of care to others. 11 July 2003
Raymond Mc Conville, FP and ER Physician Ashcroft BC Ashcroft BC V0K 1A0 Send response to journal: Re: Duty of care to others.	So we are unethical if we strive to ensure that our fellow workers and patients are not subjected to second hand smoke? I believe that as physicians we have a duty of care to our patient but also a duty of care to the community at large. Perhaps the author smokes or perhaps he chooses to ignore the information that suggests second hand smoke is harmful. In response to the patient not wishing admission for terminal care-- could he not be managed at home. In Canada, if a bar wishes to have a smoking section , staff time in that area has to be kept to a minimum and only on a voluntary basis. How many health care workers would volunteer to work in a smoky environment? Who would compensate them for any illnesses as a consequence? Competing interests:   Healthcare Professional
Banning smoking is not unethical 12 July 2003
Martin McKee, Professor of European Public Health LSHTM, London WC1E 7HT Send response to journal: Re: Banning smoking is not unethical	I am frankly amazed at this letter. Nicotine is a drug with important physiological consequences. As we showed in our editorial, there are many sound clinical reasons for stopping smoking, not least that it improves one's chances of recovery (which is surely the aim of being in hospital). If Dr Head really feels that some patients are unable to overcome its addictive properties when in hospital then they can be given nicotine replacement. This will satisfy their craving while they are in hospital while reducing the risk of fire or pollution of the environment. Or are there other potent drugs that he feels we should be allowing patients who are seriously ill to self-administer, with no idea of how much they are taking or how they might interact with the other drugs they are receiving? Competing interests:   I was an author of the editorial to which this letter has responded.
Arrogance 14 July 2003
Burt L. Jackson, Citizen 85 Kirkside Ave, Milford, CT USA 06460 Send response to journal: Re: Arrogance	The arrogance of those who would restrict hospital care to nonsmokers is a symptom of our times. These same people would likely prefer to ignore the fact that hospital mistakes kill or maim thousands each year. Nor are they likely to have considered the unhealthy aspects of hospital food. No, because these things would require soul searching and action on THEIR PART. Much easier to judge the conduct of others and make "politically correct" (and thoughtless) pronouncements. I am not a smoker. Competing interests:   None declared