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Letters to the Editor

From time to time, a commentary on the world will bubble up inside of me to the extent that I'm forced to write a letter to my local, metropolitan, daily newspaper, The Age. This is where I blow of some steam. Feel like venting too? Add your own comment or visit my homepage.

Tuesday, April 06, 2004

Surgery for Smokers

I welcome the surgical priorities debate opened in the Medical Journal of Australia (The Age, 5/4). Difficult decisions about allocating scarce resources to save or improve people's lives should be made by the community, rather than left to specialists. This is why I'm particularly disappointed with the comments by two well-known Melbourne ethicists.

Leslie Cannold says that resources should be allocated "based on need" and presents the usual "thin end of the wedge" argument about the danger of blaming people for illness. (This phrase is actually used by the government spokesman in ruling out such discrimination, contradicting the current transplant selection criteria!).

The research paper makes it clear that non-smokers should be given priority due to their better outcomes from the surgery: while the need may be the same, the same surgery does more good for non-smokers. Given the resource constraints, this prioritisation seems entirely reasonable.

The grandstanding remark by Nicholas Tonti-Filippini, bio-ethicist and occasional Catholic spokesman, that these suggestions are "akin to advocating capital punishment for smoking" clearly add nothing to the debate. Why add such inflammatory invective to the debate? No doubt Dr. Tonti-Filippini was stalling for time awaiting further instruction from the Vatican on his position.

I hope this debate continues but with much improved quality of commentary.


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