Fuming

I do know someone who allegedly was refused treatment. She had type 1 diabetes, and refused to change her lifestyle choices. She drank and ate whatever she pleased. Her first child was born with sacral agenisis. Several times, when pregnant with her second child, I found her in a hypoglycaemic coma and had to administer a glucagon injection.

She lost a leg to the condition and then her kidneys failed. She was not placed on the list for a kidney transplant (she said this was refused due to her life style as kidneys were at a premium). She underwent dialysis instead three times a week and died from a heart attack during one of the treatments.

She was 42.

I don't think doctors can refuse treatment per se but they can defer treatment until you stop, or drastically reduce, whatever it is they disagree with. I had an acquaintance who smoked and developed circulatory problems but was refused immediate treatment as 'he would be too ill and probably wouldn't survive the surgical procedure' but if he gave up smoking, they would reconsider. He managed to get it down to ten cigarettes a day over an 18 month period by which time, he was so ill, he had to have the surgery as an emergency admission - when his health was 10 times worse than it was when they first declined to treat him.

Either way, he didn't receive the prompt attention he would have had he not smoked.

But the lady in Aka's post did get medical treatment. Dialysis three times a week is medical treatment. With many people waiting years for a donated kidney, should she really have got one only to abuse it and die soon anyway from over-indulgence, when dialysis was available?

And if Holly's acquaintance had died on the operating table, would he have benefitted from prompt treatment? He probably got other treatment which did not include the surgery, but that is not as emotive a description as "refused treatment" That conjures up a picture of the patient being sent home without even a paracetamol or a sticking plaster because he drank or smoked.

Surely the refusal to give certain treatment is on medical grounds, that the patient would be no better off for it, or even worse off.

I wasn't replying, or offering a contras, to Aka's post Elegran so I'm not sure why you have italicsed the word 'did'.

As the person I mentioned didn't die when his health was markedly worse than it had been 18 months previously, it debunks the reason given. And no, no treatment, just monitored for deterioration of his condition.

Two other women I know: both have hip problems but no other health concerns; one is given a hip replacement quite quickly and is a non-smoker - the other lady smokes and is still waiting. I'm sure they have valid reasons for their choices but it would be interesting to know them.

Did was italicised as a reply to Aka, and did not refer to your post.

When I was in hospital getting a lumpectomy, I learnt that the chances of developing any infection were one in 50 for the general patient, one in eight for the smokers. Anaesthetic is dodgier for smokers than for non-smokers too.

I am not advocating refusing to treat smokers automatically, just pointing out that the habit does make treatment more complicated and more dangerous for them. It is understandable that they are encouraged to stop or cut down before getting surgery.

Did was italicised as a reply to Aka, and did not refer to your post.

My apologies Elegran - I misread that part of your post.

I agree with the rest of your post but for the gentleman concerned.

I'm puzzled by the statement that anaesthetic is more dangerous for smokers; were there more deaths, from anaesthetic, in the days of old when most people smoked? Surely it's better to treat something as soon as it prevents itself than leave it until it has progressed to the stage that it has a good grip on a person?