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Lighthawk wrote:The fuck? Seriously? What kind of fail logic is that?

It's the logic that if someone's killing themselves very rapidly as it is, why should the state spend a lot of money slowing that rate marginally?

Hmm. Should surgeons likewise refuse to treat cirrhosis in people who drink? If I have kidney failure due to creatinine build-up or excessive microalbumin, should they refuse to treat me since I'm a diabetic and therefore those things are due to another condition? Should palliative care be withheld from infants with Tay-Sachs Disease since it's their parents fault for having kids while knowingly being of eastern European descent? All of these points follow directly from the idea of refusing to treat patients who smoke. Bear in mind that it's not a refusal to treat smoking-related issues; it's a refusal to perform any surgery on a smoker.

Captain Seafort wrote:

Lighthawk wrote:The fuck? Seriously? What kind of fail logic is that?

It's the logic that if someone's killing themselves very rapidly as it is, why should the state spend a lot of money slowing that rate marginally?

First, "very rapidly killing themselves"? That comment is bullshit on more levels than I want to deal with, but I will respond to one aspect...my Aunt is past 60. She's smoked most of her life. If she's been rapidly killing herself all these years than she must have had a natural life expectancy of about 300.

Second, you want to start letting people die or live with untreated ailments because of a lifestyle choice? You really want to go down that road?

Finally, I didn't see anything that said that money had anything to do with it. The only excuse given was "the deleterious effect smoking has on the healing process". I guess if the person dies, they don't have to worry about that, do they?

I'm a smoker, and even I can understand the idea of refusing to treat a smoking-related ailment. A doctor who chooses that is a person who should have never become a doctor, but that's a different story^*. The issue is that under this pronouncement, a doctor can refuse to treat anything if the patient is a smoker. Here's a good, real-life example: my brother-in-law developed an acoustic neuroma. While he is a smoker, the neuroma was completely and utterly unrelated to tobacco use. Under the pronouncement related above, the medical profession would have refused to treat him. Instead of having the bulk of the tumor removed with only the permanent loss of hearing in one ear, it would have instead grown into his medulla and killed him by the age of 35 by interfering with basic involuntary motor functions like breathing.

So, do we really think that this young man deserved to asphyxiate in his own lungs from a non-smoking-related ailment?

^* - As to this bit, a doctor refusing to treat someone because the recovery could be more difficult due to the patient's lifestyle choice is no different in ethos than an oncologist refusing to treat certain types of cancer because they're more stubborn than others. Is a public defender allowed to recuse himself because the case might be hard? Is a soldier allowed to refuse a mission because it might be dangerous?

You don't deserve this treatment because you smoke.
You don't deserve this treatment because you drink.
You don't deserve this treatment because you don't eat properly.
You don't deserve this treatment because you don't exercise.
(....................................................................)
You don't deserve this treatment because you're not smart enough.

Where do you draw the line?

Mikey wrote:Should surgeons likewise refuse to treat cirrhosis in people who drink?

If they're drinking excessively (i.e. consistently above the recommended daily alcohol intake), then yes.

If I have kidney failure due to creatinine build-up or excessive microalbumin, should they refuse to treat me since I'm a diabetic and therefore those things are due to another condition? Should palliative care be withheld from infants with Tay-Sachs Disease since it's their parents fault for having kids while knowingly being of eastern European descent? All of these points follow directly from the idea of refusing to treat patients who smoke.

No, they don't - smoking and heavy drinking are voluntary actions that have a significant negative effect on the health of the smoker or heavy drinker. The other examples are not.

Lighthawk wrote:First, "very rapidly killing themselves"? That comment is bullshit on more levels than I want to deal with, but I will respond to one aspect...my Aunt is past 60. She's smoked most of her life. If she's been rapidly killing herself all these years than she must have had a natural life expectancy of about 300.

Some people have survived being shot in the head, with no medium or long-term ill effects. Therefore being shot in the head poses only a low risk to an individual's health.

Second, you want to start letting people die or live with untreated ailments because of a lifestyle choice? You really want to go down that road?

If that lifestyle choice has a direct and serious impact on their health, and they demonstrate no intention of modifying said behaviour, then absolutely.

Finally, I didn't see anything that said that money had anything to do with it. The only excuse given was "the deleterious effect smoking has on the healing process".

The two are linked. Since the smoking is significantly reducing the effectiveness of the treatment, the cost-effectiveness of the treatment is likewise much reduced. Since these are people's taxes being spent on said treatment, why should the state cough up to help someone who evidently doesn't want to help themselves. Note that this isn't a case of "you've been a smoker, therefore we won't treat you", it's "you are a smoker and won't stop, therefore we won't treat you."

I notice you ignore the main points which I recently raised. Well? Should my brother have been left to die for a non-smoking-related ailment - one whose treatment wasn't interfered with one bit by smoking - because he smokes? By your logic, it's a very tiny step to say that Ashkenazic Jewish children shouldn't be treated for Tay-Sachs because, well, their parents knew that they were Jewish when they decided to have kids?^*

Some treatments require the use of cortisone or other corticosteroids. Such medications play merry hell with blood glucose levels in people without internal insulin regulation. Should I be denied treatment for diabetic complications if I choose to have a treatment involving corticosteroids?

^* - Yes, I know Tay-Sachs carriers can be present in gentile eastern European populations as well, I just used that because Ashkenazic Jews have by far the highest rate of carriers.

Mikey wrote:I notice you ignore the main points which I recently raised. Well? Should my brother have been left to die for a non-smoking-related ailment - one whose treatment wasn't interfered with one bit by smoking - because he smokes?

Left to die? No. Refused state-sponsored treatment until such time as he stops smoking? Yes.

By your logic, it's a very tiny step to say that Ashkenazic Jewish children shouldn't be treated for Tay-Sachs because, well, their parents knew that they were Jewish when they decided to have kids?

It's not even close. Refusing an individual treatment due to their own self-destructive actions is a million miles away from refusing them treatment due to a condition over which they have no control.

I have to agree with Seafort on this. If the person is living a life style (By choice) that interferes with the treatment or ability of treatment then the state should have the right to refuse paying for their treatment. Once they abandon said life style, its the right of the person to be treated by the state in which they live.

Giuseppe wrote:You don't deserve this treatment because you smoke.
You don't deserve this treatment because you drink.
You don't deserve this treatment because you don't eat properly.
You don't deserve this treatment because you don't exercise.
(....................................................................)
You don't deserve this treatment because you're not smart enough.

Where do you draw the line?

Those first four are things that are completely controlled by the person. They are choices made by the person that effect their health and treatment.

Captain Seafort wrote:Left to die? No. Refused state-sponsored treatment until such time as he stops smoking? Yes.

The difference between those two statements is nominal. And you maintain this stance even though the ailment was in no way smoking-related, and it was made explicitly clear that smoking in no way affected the surgery, recovery, or treatment? I can't even see where logic comes into play in that argument.

Captain Seafort wrote:It's not even close. Refusing an individual treatment due to their own self-destructive actions is a million miles away from refusing them treatment due to a condition over which they have no control.

It's exceedingly close. From your stance, it's only one small step to the right to say, "Well, the parents knew that they were Ashkenazic but still chose to have children" - much the same way in which an individual chooses other lifestyle habits.

How about this, then? Let's say a soccer player gets injured during a game, badly enough to require surgery. Well, professional athletics are an assumed-risk activity, by all means; and further, the injury was incurred as a direct result of the patient's choice to do something with a well-known risk of injury involved. By your logic, then, he should be denied the surgery he requires. Please explain to me now how any difference between the two cases is anything other than arbitrary.

Mikey wrote:It's exceedingly close.

No, it isn't. One is in the control of the individual requiring treatment. The other is not.

How about this, then? Let's say a soccer player gets injured during a game, badly enough to require surgery. Well, professional athletics are an assumed-risk activity, by all means; and further, the injury was incurred as a direct result of the patient's choice to do something with a well-known risk of injury involved. By your logic, then, he should be denied the surgery he requires. Please explain to me now how any difference between the two cases is anything other than arbitrary.

You pointed out the difference yourself by using the word "risk". There is indeed a risk of injury while participating in physical sports. Damage to the body due to smoking or excessive drinking is not a risk, it is a certainty. The degree of damage will vary from person to person depending on their intake and various genetic factors, but that damage will be done is utterly certain.

Deepcrush wrote:

Giuseppe wrote:You don't deserve this treatment because you smoke.
You don't deserve this treatment because you drink.
You don't deserve this treatment because you don't eat properly.
You don't deserve this treatment because you don't exercise.
(....................................................................)
You don't deserve this treatment because you're not smart enough.

Where do you draw the line?

Those first four are things that are completely controlled by the person. They are choices made by the person that effect their health and treatment.

How about you don't deserve this treatment because you don't make enough money? (joking, although the issue is very real)

Anyways... you missed the point or I wasn't clear: I wasn't saying that after those 4 things the next logical step would be the one regarding intellect. All I had in mind is that once you start deciding that some don't deserve medical treatment you risk going down a slippery path. Once one thing is widely accepted, it's not hard to imagine this kind of logic being applied: if A doesn't deserve treatment and B is so similar to A, maybe B shouldn't get treatment either. If this new rule is accepted too, then someone will notice that C isn't all that different from B... so why should they get treatment? And so on...

Besides, if we were to apply those first four 'rules', which are choices that someone is responsible for, almost no one would deserve medical treatment. So how do you decide what's acceptable and what isn't? is the proverbial line so clear?

What about someone who smokes occasionally (social smoking); is that as bad as someone who smokes 2 packs a day? Do they deserve treatment or not? What about drinking? a beer once or twice a week is ok, or should I be left to die for it? What about someone who doesn't afford to have a 'proper' diet? In most cases organic food is much more expensive than 'regular' one. How much physical exercise is enough?

Wasn't there an episode in TNG, Justice I think, where the point was the law shouldn't deal in absolutes? I kinda agree with that, although that episode meant we missed an opportunity to get rid of Wesley

Ah, well, I guess what I'm trying to say is that either you give everyone access to treatment or you decide on a set of rules which are set in stone and that have been decided in a thoroughly scientific and non-arbitrary way so that they are not unfair to anyone both socially and morally. For me any law regarding this issue that comes up short of that is not worth even considering. After all we're dealing with people's lives here. I'd love to see someone come up with a draft of such a law.

As a side note: don't I pay social contributions and taxes to the state (or private schemes, depending on country), just so that I can benefit from medical care when I need it? I wouldn't pay a dime if I knew that someone might decide that despite my payments/tax money I don't deserve treatment.

I pointed out a difference, certainly - I asked you to point out a difference that wasn't entirely arbitrary. I don't see one. OK, then, let's remove that. Said footballer retires without incident, but develops osteoarthritis in his knees. In many sports, such a development is almost de rigeur, and isn't just a fact of life as rheumatoid arthritis is. By your logic, then, this former athlete shouldn't be given treatment for his knees - excepting, of course, your arbitrary decision to vindictively withhold treatment for one and not the other because one offends you and the other doesn't.

Captain Seafort wrote:No, it isn't. One is in the control of the individual requiring treatment. The other is not.

Obviously, because Tay-Sachs kills its victims by the time they are about 15 years prior to majority. But the parents would have consciously made a decision to have children, and would have known full well what their ancestry was. There are many, many people in this world who would take that baby step to the right and deduce this "logic" from the "logic" you presented.

Mikey wrote:I asked you to point out a difference that wasn't entirely arbitrary. I don't see one.

Then I suggest you see an optician, pronto.

Said footballer retires without incident, but develops osteoarthritis in his knees. In many sports, such a development is almost de rigeur, and isn't just a fact of life as rheumatoid arthritis is. By your logic, then, this former athlete shouldn't be given treatment for his knees - excepting, of course, your arbitrary decision to vindictively withhold treatment for one and not the other because one offends you and the other doesn't.

Once again, while there is a risk of damage to the body while participating in physical sports (which would include conditions that developed subsequently), damage to the body due to smoking or excessive drinking is not a risk, it is a certainty.

Obviously, because Tay-Sachs kills its victims by the time they are about 15 years prior to majority.

Utterly irrelevant to the point.

But the parents would have consciously made a decision to have children, and would have known full well what their ancestry was.

Which is related to decisions made by the individual requiring treatment...how, exactly?

There are many, many people in this world who would take that baby step to the right and deduce this "logic" from the "logic" you presented.

Baby step. Right. Just like the minute baby step in warfare from throwing a rock to throwing a thermonuclear-tipped ICBM.