tag:blogger.com,1999:blog-1694400362120888303.post1430962809500627552..comments2024-02-22T19:52:27.939+00:00Comments on The bad old days will end: A healthy choice?rayhttp://www.blogger.com/profile/08557920166206674182noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-1694400362120888303.post-47387438024653302642012-11-27T16:28:23.058+00:002012-11-27T16:28:23.058+00:00Curtailment of therapy based on judgements of life...Curtailment of therapy based on judgements of lifestyle have been doing the rounds for some time - many proposals were made under the last Labour Government too. Most of my experience has been with transplant surgery and the regular cry concerned liver transplants for alcohol abusers. I recall an audience in Brasil where I was questioned about a Brasilian playboy who had drunk his way through two livers and was on his way to the UK for another. Should the UK give him one, even if he was prepared to pay? It meant one less liver for UK patients. But once life-style is established as a reason for therapy curtailment we are on a slippery slope. Almost all disease has a life-style component. Insufficient exercise, too much exercise, over eating, under eating, unhealthy diet, working too hard, being idle, too much sex, not enough sex, living too far away from work or living too near your workplace, are all contributory factors in the assessment of disease. So for this reason I published guidelines on organ transplantation which stressed that priority should be given to an ability to cooperate with the post operative therapy, and that doctors should not make therapeutic decisions based on speculations about life-style. Of course some doctors argued that alcohol abusers might not be able to cooperate. But that really is a matter for case by case assessment. It seems our Tory doctor is not really familiar with the problem. But then, I learnt early on in my career that GPs were not that well informed about medical decision making. Their job is to treat the sick, not lecture on how to live. As for education about healthy life-style - that is fine, but not from politicians and legislators.Dr Llarregubnoreply@blogger.com