Does a pack a day keep the doctor away? It could if you are a smoker in need of lung surgery. In 2006, a UK primary care trust announced that it would remove smokers from its surgery waiting lists to cut costs. Now, in the most recent issue of the BMJ, two medical ethicists debate whether or not this decision is ethical.

Matthew Peters of the Concord Repatriation General Hospital in Australia felt that denying smokers surgery is justified: “Smoking up to the time of any surgery increases cardiac and pulmonary complications, impairs tissue healing, and is associated with more infections and other complications at the surgical site.”

“It is also true that smoking is rarely the only risk factor for a poor out¬come, and smoking should not be considered to the exclusion of all others. Smoking is, however, unique in that its associated risk can be reduced substantially within a short period,” he adds in his piece.

But Leonard Glantz of the Boston University School of Public Health says that denying smokers healthcare because they have a stigmatized habit is outright mean. He says that we would then have to be prepared to deny medical attention to many other people with bad habits. “Do patients have a general obligation to get healthy as a condition of receiving treatment? Patients are not required to visit fitness clubs for eight weeks, lose 25 pounds, or take drugs to lower blood pressure before surgery.”

I think that this is a great ethical debate for the medical community. But I believe it’s an even better issue for smokers to discuss. Knowing that enjoying a cigarette before the operation could suck money out of the healthcare system – and thereby worsen someone else’s treatment – could make smoking before surgery a real drag.

Roxanne Khamsi, Online Reporter