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Dear Editor,
The arguments over the use of 'evidence' to justify rationing and denying patients their rights under the NHS constitution are well rehearsed. (1,2) Treatment should be offered based on the risk and benefit for that individual, not on the basis of population studies.
I would like to offer a new analogy for those making rationing decisions underpinned with unethical reasoning. Suppose a study shows religion is a factor in recovery from surgery? (3) Would it be ethical to demand patients change religion or be punished with delays or denial of treatment? Now substitute whatever excuse for rationing (smoking, weight, diet, alcohol, bowel frequency etc) with religion and reconsider what you are proposing.
Competing interests:
My GMC assessment in 2015:
When talking about resource issues he said that his stance was a matter of principal [sic] and that it is a matter of how principled doctors are – the assessors took this to mean that he felt more principled than other doctors on this matter (SI 1-50). This stance was considered unacceptable.
Making excuses for unethical rationing decisions
Dear Editor,
The arguments over the use of 'evidence' to justify rationing and denying patients their rights under the NHS constitution are well rehearsed. (1,2) Treatment should be offered based on the risk and benefit for that individual, not on the basis of population studies.
I would like to offer a new analogy for those making rationing decisions underpinned with unethical reasoning. Suppose a study shows religion is a factor in recovery from surgery? (3) Would it be ethical to demand patients change religion or be punished with delays or denial of treatment? Now substitute whatever excuse for rationing (smoking, weight, diet, alcohol, bowel frequency etc) with religion and reconsider what you are proposing.
(1) https://www.gov.uk/government/publications/the-nhs-constitution-for-engl...
(2) https://www.bmj.com/content/355/bmj.i5594/rapid-responses
(3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777785/
Competing interests: My GMC assessment in 2015: When talking about resource issues he said that his stance was a matter of principal [sic] and that it is a matter of how principled doctors are – the assessors took this to mean that he felt more principled than other doctors on this matter (SI 1-50). This stance was considered unacceptable.