Saturday 21 September 2019

Dr Ciara Kelly: We can't judge patients, just try to help them

Smokers deserve health treatment just as much as anyone else
Smokers deserve health treatment just as much as anyone else

Ciara Kelly

More than a quarter of people believe that smokers with lung cancer should be treated differently to non-smokers, a study found last week. Twenty-seven per cent of people surveyed in the Marie Keating Foundation's "I am lung cancer" campaign believe that non-smokers should have their treatment prioritised over smokers - and, perhaps unsurprisingly given that statistic, 34 per cent of people in the same survey agree that lung cancer patients face stigma and 10 per cent of people think that stigma's acceptable.

All I can say is - God, I hope it stays fine for you. Because there aren't that many people who live a blameless life from a health point of view and if we were to withhold treatment based on people smoking, drinking, taking drugs, having unprotected sex, over-eating or engaging in other risky behaviours, we'd solve the trolley crisis overnight because our Emergency Departments would be empty of patients.

And I imagine that many of the people pontificating on prioritising ''good'' non-smoking patients ahead of ''bad'' smoking patients probably do various things themselves that increase their risk of cancer or other illnesses, yet they still feel comfortable in passing judgment on lung cancer patients as not being worthy of care.

This is the very same attitude that existed in the 1980s when some people suggested that gay men developing HIV ''deserved to be sick'' and shouldn't be treated because of their sexual practices. It is also one of the drivers behind anti-HPV vaccine sentiment - the idea we shouldn't vaccinate people against a cancer-causing STI because people should have to live with the consequences of their own actions (that they clearly don't approve of.).

Luckily, the medical profession isn't that judgmental. Or maybe it's just that we've seen first hand the ravages of cancer, so why someone is sick is irrelevant when you're faced with someone in need of compassionate care.

The very best example I've seen of this was recently; Dr Jeff Cohen is a Jewish doctor who treated Robert Bowers after he shot and killed 11 people in a Pittsburgh synagogue that Dr Cohen himself attended. I can only imagine what he was feeling having lost friends in a random act of violence by an anti-semitic murderer. But he still put that to one side and tended to him after he was shot by police. That to me is the epitome of what medicine should be; blind to everything except a person's need for treatment.

All too frequently we hear judgment being passed on patients - smokers are only one group we feel happy to blame. Overweight people are another. Put up their health insurance is a regular cry. Make them pay higher tax! But life isn't black and white. You never walk another's road and you don't know why someone smokes, drinks, has unprotected sex, over-eats or anything else!

And equally you can get sick without ever having taken any risks with your health. Many people who never smoked get lung cancer but that doesn't mean their lives are more important than a smoker's. That just means that there's no certainties in life. Yes, you can play the odds but life isn't always ''fair''.

For my money, I think there are certain groups we smugly look down on, and smokers and people who are obese are two of them. You never hear anyone suggesting that women with breast cancer who don't drink alcohol should have their treatment prioritised ahead of those who do -even though alcohol is a risk factor for breast cancer. Because, quite rightly, we don't stigmatise people who have a couple of glasses of wine. But we feel free to happily condemn those who smoke for some reason in a much more callous way.

Perhaps we should just accept as a society that it is not the job of health care to rank patients according to some kind of how-much-they-are-to-blame-for-their-own-illness system. But instead simply to treat those who are unwell. Whatever they've done or not done, they are sick - leave them alone. Let he who is without sin cast the first aspersion.

@ciarakellydoc Ciara presents Lunchtime Live on Newstalk, weekdays 12-2pm

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