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Doctors To Breathalyse Smokers Before Allowing Them NHS Surgery (bbc.com)
Smokers in Hertfordshire, a county in southern England, are to be breathalysed to ensure they have kicked the habit before they are referred for non-urgent surgery. From a report, shared by several readers: Smokers will be breath-tested before they are considered for non-urgent surgery, two clinical commissioning groups (CCGs) have decided. Patients in Hertfordshire must stop smoking at least eight weeks before surgery or it may be delayed. Obese patients have also been told they must lose weight in order to have non-urgent surgery. The Royal College of Surgeons (RCS) said the plan seemed to be "against the principles of the NHS (the publicly funded national healthcare system for England)." A joint committee of the Hertfordshire Valleys and the East and North Hertfordshire CCGs, which made the decisions, said they had to "make best use of the money and resources available." Patients with a body mass index (BMI) of over 40 must lose 15% of their weight and those with a BMI of over 30 must lose 10%, or reduce it to under a 40 BMI or a 30 BMI - whichever is the greater amount. The lifestyle changes to reduce weight must take place over nine months.
What do you think the phrase 'non-urgent' means?
A friend of mine was talking to a surgeon (a friend of his) about the risks of some surgery, and the doctor quoted his own success rates, so maybe he said "8% had a bad outcome" (I forget the number but it was in that range) but then he added, "but please realize every single one of those patients had serious complications such as being morbidly obese, usually with diabetes", etc. In those cases the risk of not doing the surgery was certain death, so the patient and doctor had little choice but to take the risk. However, I can see why a surgeon would want to avoid "non-urgent" surgery on a patient if they could significantly reduce the risk by losing some weight first.
"I have never let my schooling interfere with my education." - Mark Twain
Um, but isn't this exactly society forcing you to?
What to you think the phrase "step towards them" means?
A slippery slope toward logical fallacies?
We've always had "death panels" in that we've never been able to afford to keep treating people with every last-ditch expensive possibility and always need to decide when it's better for the patient's comfort to just give up.
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How long before we see this catch-22 in the Daily Mail:
Guy with bad knees can't walk. Gains weight. Needs knee replacement surgery. Ordered to loose weight before surgery can be approved. Told to get out and walk more to loose weight. "I can't walk!" Sorry, sucks to be you. BTW, I see you have a liver donor card...
I don't think this falls into slippery slope territory. Smoking and obesity aren't things that increase risks in your surgery by something small value, they increase it by large values. Acting like this is some slope that leads us to "death panels", is much like saying, "The Federal government mandates seatbelts, next thing you know they'll be installing cameras in your car and watching you every minute you're in your car." or my personal favorite, "You let your barber cut your hair, next thing you know they'll be lopping off your limbs."
It might be just me, but I think we're really reaching here thinking that this is a gateway to death panels in any country.
Now the big question is will this result in the patients improving their health before surgery or will surgery just get deferred until it's urgent?
When someone says, "Any fool can see
The baby died because its condition was untreatable, no matter what some dodgy US quack says.
When you've stopped being the place that Andrew Wakefield legged it to so he could continue spouting lies about mercury and autism and profiting off three-jab vaccines, come back to us.
Which wouldn't bother me if we had private-funded healthcare as a viable option. But since we don't, I guess it's up to Big Brother, since the moment a third party pays, it's no longer just about me and my doctor, right?
It's not society's job to do it for you
Unless you have socialized medicine, then it is. At the same time, if "society" is footing the bill for your medical care, you shouldn't be surprised when "society" puts constraints on your behaviors.
Makes sense to me. Now tell us how you feel about drug tests for recipients of public assistance.
Which wouldn't bother me if we had private-funded healthcare as a viable option. But since we don't, I guess it's up to Big Brother, since the moment a third party pays, it's no longer just about me and my doctor, right?
That third-party being either the Government or private insurance - so how are they different? I private insurer can deny you coverage or payment for treatment and can have their own rules for access to care/procedures.
It must have been something you assimilated. . . .
We already have death panels in US healthcare.
They are called medical insurance claims processors, or adjusters.
In the UK? Yes, we have private-funded healthcare as an option - go take out any one of the dozens of private healthcare plans and check yourself into a Spire hospital for whatever you want cut off, adjusted, added or fondled.
The NHS isn't the only option in the UK.
But be warned - if you arrest on the private hospitals operating table, they are 100% going to be calling an NHS ambulance to deal with it.
Whats the Fucking Spaghetti Monster have to do with the price of rice in China?
Higher consumption of spaghetti would result in lower consumption of rice, resulting in lower demand and thus lower price.
http://spamdecoy.net - free throwaway anonymous email - avoid spam!
The CSRs have already been found to be in violation of the law by a Federal Court. They were only allowed to continue because the ruling has been under appeal since it was made last year.
Appropriations for the CSR was never part of the ACA and by law, and yes the constitution, only the legislative branch can appropriate the money to pay for them and thus far they have declined (both Dems and Reps). Obama used his 'pen and phone' powers (I can't seem to find those defined in the constitution but apparently you have a different copy) to use a completely different fund to make the payments, Trump is simply putting an end to that practice.
At any time Congress can actually pass real legislation to appropriate money for the CSR payments and then they would be perfectly legal. There has been some movement in that direction, but as of today, as they have been since most of the time the AHA has been active, they are a complete fabrication of the Executive branch and have no legal standing.
Of course that's just my opinion...... you could be wrong!
It wasn't "up to the government".
The child had rights independent of its parents - the doctors and hospitals are required to protect the patients rights, especially when they are being violated by the parents.
It was the hospital that went to court to fight the issue - not the government.
The government had no involvement in the case.
Of course, you do know all about the case, right? A few points for you to consider:
1. The US doctor, Professor Hirano, pushing the treatment had massive financial interest in his own treatment
2. He had never actually tested his treatment on the condition Charlie Gard had, not even in animals
3. International experts were consulted for second opinions by the hospital all the way through the case
4. Professor Hirano was invited to consult on the case in January 2016, but did not take up the invitation until July 2017
5. Professor Hirano stated in court that he had supplied opinions to the court without examining the patient, reading his notes or studying any scans taken of the patient. He basically admitted to the court to "guessing" without being in possession of any medical facts about the patient.
No - you are voluntarily choosing not to use the NHS, thats your choice. The NHS will always be there to scrape you off the road after a car accident, to treat your cardiac arrest when you fall over in a shopping mall, to reset your broken leg when you fall down stairs after a boozy night out.
It will always give you treatment - just not on *your* terms alone. And thats perfectly fine.
Slippery slope does not apply when there is a clear, inevitable path from point A to point B. If I tell you that if you keep increasing the pace of your binge drinking it is going to ruin your liver, I have not made a slippery slope argument. I've told you that A must lead to B. There is not enough money to give every person every medical service that they would like. At some point, someone would have to decide who gets what. In a western culture, that decision maker would most likely be a panel ('cause that's how we roll). That panel would be deciding who lives and dies, i.e. a Death Panel.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
Once again, the government was not involved in this case - it was the hospital against the parents.
There is an overriding "right" beyond the "right to live", and that is "the right to not suffer at the hands of others", and that was the right being protected here.
The child was already brain dead - he had been since January 2017. He had no prospect of recovery, no prospect of any quality of life and yet the parents wanted to keep him alive artificially and subject him to unproven, untested treatments (which is illegal in the UK) by a doctor with a significant financial interest who hadn't actually taken any *medical* interest in the child.
What about people who like running or sports? They are putting extra stain on their knees. Should they be required to give up running for good to get that knee fixed?
Maybe the queue could be ordered based on an evaluation of each patient's risky behaviour. Do they drive? Do they live in an area with bad air quality? What is the criteria?
What about people who gained weight as a result of the thing they want fixed? Bad knee, less exercise... Weight gain is not an uncommon symptom of many ailments. What if it's due to some other health problem unrelated to the knee, does that count?
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SJW, n: "Someone I don't like, and by the way I'm a fuckwit" - AC
It's elective surgery, not car crash surgery.
The reasoning is sound. The cost of the procedure goes way up if you're overweight, and since surgery is one of the most stressful things yor body will ever experience, you're more liskely t push an overwight body to failure when you're under the knife.
https://health.usnews.com/heal...
What art of "costs more, and is more likely to kill the pateint" don't you understand?
Smoking increases risk of complication, but not as extreme as weight.
https://www.ncbi.nlm.nih.gov/p...
Man is the animal that laughs.
And occasionally whores for Karma.
It's not society's job to do it for you
Unless you have socialized medicine, then it is. At the same time, if "society" is footing the bill for your medical care, you shouldn't be surprised when "society" puts constraints on your behaviors.
Makes sense to me. Now tell us how you feel about drug tests for recipients of public assistance.
The idea behind drug testing for for recipients of public assistance is for States to save money by booting out drug users. It has been implemented in 7 U.S states and not only did they find that drug rates usage among recipients on all states was below estimated usage among the population at large (in most of them significantly below), all the states ending up loosing money to the testing programs due to the cost and low rates of drug usage. Not only do all of these States continue this ineffective program, it has been proposed in several more states as the true driver behind it is Conservative ideology that the poor are mostly lazy addicts. Something which ironically their own data disputes
I am not a surgeon, but I am a doctor who recently finished residency. Testing for recent smoking is a very good policy, and it will save lives and reduce complications, as smoking interferes with recovery from surgery like you wouldn't believe. Even if a patient can't stop smoking long term, they need to at least stop for a few weeks (preferably for at least a few weeks before and a few weeks after surgery).
Cigarettes are a vasoconstrictor, meaning they cause blood vessels to clamp down, reducing blood flow. It contains carbon monoxide, which reduces oxygen carrying capacity. It suppresses the immune system -- all this interferes with wound healing, and the post-surgical period is often a race between wound-healing and breakdown/infection. Patients literally can have poorly healing surgical sites split wide open or bits of themselves turn black and necrotic, because they couldn't stop smoking at least temporarily.
Smoking is pro-coagulant, increasing tendency of blood to clot -- this is not a good thing, as it tends to do so in all the wrong places at the wrong times, and a major potential complication with bed-bound patients and patients recovering from surgery can be abnormal blood clots in the veins and lungs. It paralyzes the respiratory cilia that clean your airways, and it reduces lung function, at a time when a patient is at elevated risk for pneumonia.
You want to keep smoking after you're all done healing up? Fine, we'll tut-tut at you about the long-term risks when you're following-up in the outpatient office later, but stopping around the time of surgery can literally be a matter of life or death.
Socialized medicine inverts the usual relationship and gives an effective monopoly to the consumer who can then dictate the terms, not least because they collectively (and with the help of surgeons, statisticians etc) know how much knee operations do and should cost.
Of course there are other reasons why the US spends twice as much as everyone else on healthcare, for instance the amounts each physician, insurance company, health scheme, hospital and drug company takes out in profit and spends on advertising, billing, lawyers and other extra administration.
The consumer of course pays the costs of this immense added complexity and if they're insured have the extra benefit of spending hours working out what's covered and worrying about how much they'll still have to pay (and then the insurers say no that's not covered).
There's also the human cost to those who can't afford the right healthcare or even the copay and have to wait till they're sick enough to qualify as an emergency.
This isn't the first time you've got something this wrong, not just ordinary wrong but completely backwards wrong.