Intended for healthcare professionals

Views And Reviews

Delaying surgery for obese patients or smokers is a bad idea

BMJ 2016; 355 doi: (Published 19 October 2016) Cite this as: BMJ 2016;355:i5594
  1. David Shaw, senior research fellow
  1. Institute for Biomedical Ethics, University of Basel, Basel, Switzerland
  1. davidmartinshaw{at}

Targeting specific groups of patients is illogical and unethical, says David Shaw

It was recently reported that Vale of York Clinical Commissioning Group planned to delay all elective surgery for obese patients for a year until they lost 10% of their weight and to smokers for six months unless they stopped smoking for eight weeks.1 The overall rationale for this policy and the clinical rationale for targeting these particular groups are unclear.

The most obvious objection to the policy is that it is unfair to target specific groups of patients in this way. Why should obese people and smokers be singled out? The rationale cannot be clinical risk: though surgery is riskier for morbidly obese patients, and smoking is bad for your health in the long term, mildly obese patients and smokers are just as likely …

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