Lifestyle choices and responsibility for our healthcare – whose hands is it in?

by Jane Keep, Phd, Mphil, MSc, FCIPD, MIC, CMgr, FCMI, London

A while ago, a healthcare organisation in the UK made a decision that it would no longer treat patients who are obese or who smoke – unless they have been/are on a programme to do something about it. This caused quite a disturbance at the time, in that many felt this was unfair and discriminatory. This tactic has been tried before, and each time it causes a bristle of comments, discussion and reactions.

The NHS in England has always been ‘free to patients at the point of delivery’ so whilst there is no charge for treatment, there has always been struggles to resource the NHS to be able to treat all the patients that need treating. In recent years the numbers of those needing care have escalated, and the NHS is now bursting at the seams and in financial deficit.

If we look at this further – ‘according to the Hippocratic tradition, the guiding principle for physicians is “first do no harm,” or non-maleficence, which is closely followed by the obligation to “do good,” or beneficence’.(1) It has been stated that ‘irrespective of the “rightness” of smoking behavior, physicians have a duty to offer all patients appropriate care and supportive care and to help their patients become tobacco free.’(1) This means that ‘physicians are discouraged from refusing treatment simply because they disagree with their patients’ decisions or lifestyles’.(1)

But, what if this decision is made, not on the basis of whether someone disagrees with a lifestyle choice, but on the basis of other considerations:

  • The NHS has finite resources that are so stretched now and the deficit continues to mount, and there simply isn’t enough resource to go around or to meet the ever-increasing demand on illness and disease.
  • There are many articles that show how lifestyle does affect our health and wellbeing – smoking and obesity (or rather sugar and other factors related to obesity) are part of these studies.(2) So dealing with the lifestyle ‘elephant in the room’ rather than patching up and treating illness would and could help wellbeing more sustainably.

For well over a decade the NHS has been promoting ‘Self Management’(3) of chronic illness and disease, in a bid to hand back responsibility for wellbeing, and the management of chronic conditions back to patients. This has not really taken off in the mainstream NHS and remains on the periphery.

Why is this? Why are we unwilling to take responsibility for our own health and wellbeing, and to take part in the management of our own illness and disease?

We have health services that are under severe pressure with finite resources and increasing rates of illness and disease and multi-morbidity – a combination that spells disaster and one that we can ill afford.

We know that lifestyle is a major factor in the reason for the rising rates of illness and disease, and with this comes the responsibility we have for our own lives and how they affect not just us, but others too. At what point could organisations like the NHS take a stance – knowing that lifestyle is such a key factor? And what stance could or should it take?

More so, if we all started to observe the way we are living our own lives, and the responsibility we currently do or don’t take for ourselves, we not only support ourselves, but in doing that, we will be supporting the health service – and our fellow brothers in humanity – as, if we decrease our own burden on the health services, we allow others, more sick or elderly, access to the care they need.

And in addition, we may just find we have the key to our own health and vitality:

The moment you stop and ask yourself –

why do I live like this?

Why do I eat and or drink this way?

And, why do I self-sabotage so much?

–you have opened yourself up to recognising

the possible root cause of your ill ways.

Following through on the questions alone will

Begin the much-needed changes.

Serge Benhayon Esoteric Teachings and Revelations: A new study for mankind. Unimed publishing 2011. 


So what if the key to health service reform and improving health and wellbeing rests more in our hands than we currently like to believe or consider?

What if, simply by taking full responsibility for our own lifestyle choices, we can bring untold benefits to our own health and wellbeing and significantly reduce the burden on our pressurised health services – well worth considering?



  1. Can Physicians Refuse Treatment to Patients Who Smoke? Timothy M. Pawlik, MD, MPH, Ian N. Olver, MD, PhD, Courtney D. Storm, JD, MBE, and Maria Alma Rodriguez, MD
  1. Serge Benhayon (2011) Esoteric Teachings and Revelations: A new study for mankind. Unimed Publishing




897 thoughts on “Lifestyle choices and responsibility for our healthcare – whose hands is it in?

  1. I love that you have proposed the necessary responsibility that needs to be taken to reduce the burden of ill choices on the health services. Countless people take these services for granted, often arrogantly expecting them to fix whatever ailments arise whilst in denial of the fact that many may not have needed to use the stretched resources in the first place should they have been making more loving lifestyle choices.

    1. I agree Samantha, there is a huge arrogance that we humans have towards our health and in what we expect the health services to do for us without us in turn taking our share of the responsibility for our health.

  2. With 95% of mankind sick from their choices, health services everywhere are basically bankrupt though we don’t like to use that word preferring to call it overspent instead. The situation is forecast to get worse, we can all see it will get worse because no one is changing their behaviours so it is inevitable that the systems will collapse unless patients start to take their share of the responsibility for their own health rather than expecting someone else to fix us.

  3. It would make sense that at the moment there is only an imbalance because people are misusing the system, when it would be used correctly and with consideration of everyone living in the UK it would naturally be balanced. We might complain but I agree that it is a very wise choice to look at our way of using the system and if there is something we can do.

    1. This is a great point Lieke Campbell. How often do we consider that the system of health care has been set up yes to care for those who need support but are we stopping to care for the quality we choose to live and what this system is truly about?

  4. The Doctor doesn’t come home with us. Often what we share with them is not the full truth of how we live. Yet we want them to be the absolute remedy to any illness our bodies are impacted with. To me it is simple maths. I am the only person that lives with me 24/7. So, ultimately, along with medical support where needed, I am am the one who can be my greatest ally.

  5. It is very telling of the level of responsibility that generally humanity is currently willing to take that self-management programs have not taken off. Probably also a reflection of the quality of these self-management programs which from my experience in health care are usually not supportive enough for the patients and do not get to the root cause of their lifestyle choices and behaviours.

    1. and in that Andrew you raise another question – what if those who ran the self-management programs were shining examples of having turned a condition around – not simply managing a condition?

  6. Some simple lifestyle choices can have huge changes in how we feel. Just recently I was speaking to a woman who had been experiencing inflammation. She shared how she had been experimenting and had stopped eating dairy, increased her water intake and began walking and felt so much better for it. Simple changes such as these can have powerful responses in the body.

  7. “Why are we unwilling to take responsibility for our own health and well-being, and to take part in the management of our own illness and disease?” Such a pertinent question Jane. As changes in lifestyle choices make such a huge difference to illness outcomes – and are now more accepted and published in the media, even by some courageous doctors who are speaking out – is it that we don’t want to take responsibility for our choices in un-making the disease? For if we can un-make an illness we must have played a part in making it too.

  8. Years ago I would have been looking for the big changes to make the most difference, i.e. if I lost 3 stones, or I got fit, but what I have come to realise is that it is the smallest of changes with a consistency that have made the most impact on my life and sense of well-being.

  9. Beautiful Jane how you give everyone a clear view that we all have the key in our hands to reform the healthcare system, we cannot point our finger without looking at what we live ourselves. And how you make it about a shared responsibility so more sick or elderly people can have access to care when we support seemingly only ourselves but in truth we support other people who are in a higher need of care.

    1. and how different it would be if we all worked together on this – we all (healthcare professionals, the public) asked what is going on and what can we collectively do to make a change.

  10. In the context that health care systems have limited resources and the ever-increasing demand of illness and disease is likely to exceed these limits, it makes absolute sense to support their own health and wellbeing that the patients who access it and the staff who work in it live in a way that is focuses on preventative health care and the responsible management of their own lifestyle choices and chronic diseases.

  11. There is the obvious: people who are obese, or have diabetes, or smoke. These are clearly self-inflicted conditions related to life style. And then there is the less obvious: a host of other conditions also related to life style that not many would say are related to life style. Thus, we have two options: to penalize people because of the chosen lifestyle or to start a serious, encompassing conversation on life style and dis-ease.

    1. You raise another point here Eduardo – how we can look over at another and maybe feel smug that we are not obese or have diabetes – so we ‘must be okay’ – and yet inside our body can still be rotting or suffering with some form of illness and disease if we are not truly taking care of it.

  12. Julie, you show here with wonderful expression, how important it is to look beyond the surface level of facts and scientific research – to go with a deeper enquiry and ask ‘but why do we do that in the first place’? As it is perhaps through this exploration of human behaviour that we can come to some of the more fundamental influences that are either directly or indirectly affecting us all. And this to me, makes you a true scientist of life.

  13. In taking responsibility humanity will begin to again feel the essence of being that each person holds. Again connecting to the true, tender, sensual person that for so long has been hiding inside. From there the sense that there are many ways we live that doesn’t support such beauty will be unmistakable and then naturally stopped. Responsibility is definitely a very needed quality to again introduce into our lives.

  14. In order to truly we heal we need to start looking at our lifestyles choices. I would love to know the follow up of this where ‘the organisation in the UK made a decision that it would no longer treat patients who are obese or who smoke – unless they have been/are on a programme to do something about it.’ to see how this unfolded for both patients and professionals. A great blog on a very important topic.

  15. In the news this week in the UK; Politicians are trying to get a tax put on plastic-lined paper cups that coffee comes in. 2.5 billion cups a year that are thrown away and only 1% is recycled. Is this one more frantically waving your right hand and saying don’t look at my still left hand? What is the root-cause of this consumption? Could it be, a lack of being responsible for our choices and the way we are living?

  16. I think it is really important that we each take responsibility for the way our lifestyle impacts on our health and wellbeing, and this is something that we can keep deepening our awareness of. I don’t think it’s about judging people for their choices, nor any kind of punishment but about being real about the consequences of our choices and seeing the knock on effect on others that also has.

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