Wednesday, February 20, 2008

Anti-Smoking Group Asserts that Physicians are Killing 40,000 U.S. Smokers per Year

According to the national anti-smoking group ASH (Action on Smoking and Health), U.S. physicians are "killing more than 40,000 American smokers each year." This killing is occurring, according to ASH, because physicians are failing to advise their patients to quit smoking and to offer appropriate medication or other smoking cessation services.

According to the ASH statement:

"Public interest law professor John Banzhaf ... has written to the health commissioners of the fifty states suggesting that they warn their state's doctors about such [malpractice] law suits based upon a recent article in a leading medical journal and an even more recent study about saving smoker lives. The letter notes a recent study which shows that physicians are killing more than 40,000 American smokers each year by failing to follow federal guidelines which mandate that the doctor warn the patient about the many dangers of smoking and provide effective medical treatment for the majority who wish to quit."

The Rest of the Story

I think it is really going too far to state that physicians are killing their patients. It is one thing to note that the failure to advise patients to quit and to provide them with smoking cessation services results in more than 40,000 smokers dying each year (let's stipulate, for the sake of discussion, that this is correct). But it is quite another to assert that these physicians are killing their patients.

Just because someone fails to do something which could prevent a death, it doesn't mean that he has killed that person. Killing is generally viewed as an act of commission, not as one of omission. Perhaps in extreme situations of neglect of a dying person, one might make an argument that someone has killed another individual. But this hardly represents that kind of extreme neglect.

Of note, the report itself does not assert that physicians are killing their patients. This is language that is attributable solely to ASH. If I were the organizations that issued the report, I would be angry at ASH for misrepresenting my report and for implying that I had made such an assertion.

It really doesn't say a lot about the current state of the anti-smoking movement that it is accusing physicians of killing their smoking patients. This simply goes to further undermine the credibility of the movement. If the movement goes out and claims that physicians are killing 40,000 smokers each year, who is going to listen to the movement when it makes claims that really are valid? It is a disservice to the movement to undermine its credibility like this.

Moreover, I find it quite disrespectful of physicians. Sure, they [we] may not be the perfect deliverers of preventive medical care, but the lack of time that physicians have to deliver such care hardly makes the failure to provide smoking cessation services the equivalent of killing their patients.

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