Intended for healthcare professionals


Should smokers be refused surgery?

BMJ 2007; 334 doi: (Published 04 January 2007) Cite this as: BMJ 2007;334:21
  1. Leonard Glantz, professor of health law, bioethics, and human rights
  1. 1Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
  1. lglantz{at}

    Last year a primary care trust announced it would take smokers off waiting lists for surgery in an attempt to contain costs. Matthew Peters argues that denying operations is justified for specific conditions but Leonard Glantz believes it is unacceptable discrimination

    One of the noblest things about the profession of medicine has been its single minded devotion to patients. Doctors routinely treat patients who are despised by the society in which they live—enemy troops, terrorists, murderers. Given this, it is astounding that doctors would question whether they should treat smokers. The issue for doctors is whether they will allow the current antismoking zeal in America, the United Kingdom, and western Europe to infect their practice and undermine the doctor-patient relationship.

    In a surprisingly short time smokers have gone from being the victims of tobacco companies to perpetrators of wrongs against others. Secondhand smoke used to be an annoyance but is now treated as a poisonous gas. Smokers' diseases were previously seen as the result of a heartless tobacco industry preying on the young and supplying drugs to those it addicted. Tobacco companies used to win every lawsuit brought against them by diseased smokers because they successfully …

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