Wednesday, November 11, 2009

Hertfordshire Man Denied Surgery to Repair Broken Arm Because He Smokes

According to an article in the Daily Mail, a Hertfordshire man with a severe disability due to a badly fractured arm has been denied surgery to repair the arm because he smokes.

The man is a plumber who is unable to work due to the injury, which he suffered 10 months ago after falling down the stairs. He was treated immediately with a plaster cast but the repair was unsuccessful because the bones were too far apart. It was determined that he needs an operation to insert a metal plate to properly repair his broken humerus.

An operation was scheduled in May 2009 to perform the appropriate repair; however, the surgery was canceled because the patient failed to follow the surgeons' advice to quit smoking.

Nick Carver, the chief executive of the East and North Hertfordshire NHS Trust, stated: "In canceling Mr Eeles' two operation dates, our surgeons were acting on clinical grounds only. If they are guilty of anything, then it is of having the best clinical interests of their patients at heart."

The Rest of the Story

This is disgusting. There are no valid clinical grounds to deny a patient surgery to repair a severely broken bone on the basis of his being a smoker. All this amounts to is the surgeons and health trust punishing this poor man for failing to follow their advice. But you don't punish someone by denying them a necessary surgery. If we punished all patients who fail to heed their doctor's advice in this way, we would perform almost no surgeries.

While I'm not familiar with clinical treatment in Great Britain, I am quite familiar with surgery for broken bones in the United States, and I have never seen a patient refused surgery to repair a severely broken bone because he or she smokes. In fact, to delay the surgery for that reason would likely put the surgeon at risk for a malpractice suit, because the longer you wait to repair the broken bones, the more damage that is done and the more difficult it becomes to do the repair successfully.

In my view, this represents medical malpractice. How the surgeons could possibly argue that they are acting in the best clinical interests of this patient is beyond me. The very fact that they are making such a judgment for the patient is extremely scary. Physicians are supposed to be in the business of treating injuries, not lecturing their patients about unrelated health behaviors and then punishing those patients by denying them the clinically indicated repair.

(Thanks to GreatScot for the tip.)

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