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




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

  1. The ‘first do no harm’ principle of medicine can be left to perspective if we are not careful and deliberate in its delivery.

  2. When we consider our own body as one cell in the body of humanity, then the way we take responsibility for caring for our body is reflected in the health of the whole.

  3. This quote by Serge Benhayon reminds me of the innocence and simplicity often forgotten when it comes to dealing with an issue. We seek a solution, we like to devise a big strategy etc., but these kind of very basic questions are the breadcrumbs that would lead us back to the root cause of it all.

  4. A much needed discussion for all the healthcare systems in the world for many are on the edge of bankruptcy and when this happens no-one will look at their own part in it. Most people consider diseases something that just happens to them and haven’t realized yet how much we can do for ourselves and our bodies by making different lifestyle choices.

  5. As a society we have an expectation that the NHS will fix us, we are able to do a great deal of self healing when we take responsibility for our choices and the way we live.

  6. It seems a pretty courageous act, for a health care organisation to ask it’s patients to begin to take full and complete responsibility for their health and well being first, before seeking treatment from them. This is paving the way forward for what true health care will eventually be – a part of a self-caring society that knows what it is to heal.

  7. Through the inspiration of attending courses at Universal Medicine, I have started to take much greater care of myself and my body. I have lost around 15 kilos and kept it off quite effortlessly, stopped smoking and drinking, and was eating far more nutritious meals. When I had day surgery last year, the anaesthetist commented that I was in good shape and that should stand me in good stead for the surgery. It was a real stop moment to appreciate the care I had taken for my body and how it is absolutely my responsibility to take a vehicle that is well looked after in for repairs.

  8. Paying attention to HOW we look after ourselves is a worthy investment in every capacity, and building a body through exercise, our diet, our rhythm and sleep that we feel supported by and confident with has an impact on every single thing that we do.

  9. “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?” This is a great and very needed question to be asking, but it’s actually very concerning that we need to ask it at all. After all it is our own body, the one that supports us from birth to death, we are talking about, so why would we not want to care for it as deeply as we can? The answer to this will be the difference between a world that is becoming sicker by the day and a world where people live in a most vital and healthy way.

  10. Agreed 100% Jane. It really does seem to be the height of selfishness and arrogance for us to willingly indulge in a lifestyle that knowingly make us unwell and then expect a system to take care of the mess we have created, correct the disease or prop us up so that we can continue on the same dishonouring ill-path. There is no true empowerment or healing in this way of being and I have experienced this first-hand as I also have been part of this myself. The pressure we impose on society in many ways hinders our advancement of ourselves and together as a humanity as our resources are consumed by band-aids and props and not truly healing the ill-momentums that hold us back from freely living with true vitality and well-being.

  11. We all know that smoking damages our lungs yet we still smoke, we all know that alcohol is a poison yet we still drink alcohol and we all know that eating sugar leads to an increase in obesity yet we still eat sugar so that tells me that there is far more at play than what we want to know, admit or recognise. We are intelligent beings, every single one of us so why is it that we don’t want the answers that will support our health and wellbeing? Could it be because we enjoy the comfort of what is mentioned above before the condition of our health and wellbeing? And if so, isn’t it supporting the health system and each and every one of us in some way or another when we are asked to look more closely at our own health and wellbeing even if it is suggested to not treat those who smoke or are obese unless they are on a program supporting them? To me that is true love rather than feed the system which is not supporting the individual to make the necessary lifestyle changes that are needed to bring about a healthy and well looked after body and mind.

  12. Asking ourselves why we do an unwanted behaviour and observing how we are with it helps us understand the bigger picture and thus the possibility of changing this behaviour without a force or discipline but with love for ourselves.

  13. With the ever increasing demand on healthcare resources and the link that has been made to lifestyle behaviours being a contributory factor in our illness and disease, it makes sense that we need to empower ourselves and reflect to others that taking responsibility for the quality in which we are living benefits our society as a whole and that we can make changes to turnaround our health and well-being when we start taking care of ourselves by listening to what feels true for our body and responding in a way that truly supports and nurtures us.

  14. Today I heard the estimation again that the NHS won’t be able to pay for any other illness than Diabetes in 22 years time and it really stopped me for a moment. This is shocking but in a way if it happens it will create a calamity that might stop us and make us question our ignorance and lack of taking responsibility. It would be better if this happens before though because there is so much wisdom known about how to prevent lifestyle diseases and its more than time and we are more than worth it to take heed of this.

  15. The sad fact here is that we don’t want to take responsibility for our health because it means adjusting the way we live and if we are really honest with ourselves, we don’t want to give this up, even if the way we are living is not supporting our levels of health and vitality. Metaphorically speaking it is a case of wanting to ‘eat our cake and have it to’, as the saying goes. Except in this instance it is the cake (a symbol for the comfort we crave) that is causing us the dis-ease in the first place!

  16. It is irresponsible to think that the NHS system can be propped up forever and more money will be poured into it regardless of where that money will have to come from. Maybe, if it did fail, it would make us sit up and take notice, appreciate the support we have had all of these years and to do our part.

  17. I think learning about the impact of our lifestyle on ourselves and everyone else should be a key foundational topic at school from young, something that we support everyone to grow up appreciating the importance of and having the space to discuss, learn about and evolve with.

  18. I feel we all have a shared responsibility for healthcare and well-being, not only for ourselves and the way we are living that affects all our choices and how we interact with everyone but also in supporting and empowering each other to bring integrity and care as a true foundational standard for us all.

  19. Type II diabetes is going to cripple the health services of the world very quickly… There was a study recently where a control group of 150 people with type II diabetes agreed to lose 15 kg over a reasonable period of time. Of those that did, over 90% came off all medication and no longer had diabetes… Responsibility is huge!

  20. When you start to take responsibility for your own health and lifestyle choices you realise that there is so much more to be aware of and to take responsibility for.

  21. I love the Serge Benhayon quotation, it makes total sense to me. When we are able to stop and question our life, be honest enough to admit we self sabotage we open ourselves up to seeing what the root cause of our illnesses are. The problem is our spiritual pride, we do not want to admit that we are the cause of all our ailments and issues in life.

  22. How many lifestyle choices are not ours? What have the role models we have observed growing up offered us? The pressures of parenting and the short cuts taken; cook a meal or take away fast food? Work hard all day and rest as a couch potato. Lifestyle choices can be changed but normally only after the ill effects manifest in the body. What if we impressed at a young age diet and lifestyle choices as kind of future medicine healthcare today?

      1. Yes this will have to change and be what our future education entails as our current way of championing and soliciting the disregard of our body through our chosen lifestyles is not working and making us sick because our understanding, willingly so, of the magnitude of the potential of what our vehicles offer us and are calling for us to live is lacking. All of which begins with understating and accepting of what responsibility is.

  23. There is something about our attitude as human beings when something is made available to everyone equally, for free, that develops arrogance instead of appreciation, a sense of entitlement or undeservingness.

  24. What a powerful quote from Serge – that we can make the next loving choice simply by asking the question – why do I do what I do? And so starts an amazing experiment with our bodies that will challenge our ideals and beliefs and ask us to develop a relationship with our bodies.

  25. People often complain about healthcare services and yet never consider themselves to be just that; a health care service to themselves. Perhaps they could consider applying some of the critique to the service they provide themselves with in relation to improving and supporting their own health.

    Cutting waiting lists and times for public services could be applied to themselves as not delaying in taking action that they know is required. Being underfunded could be allowing resources to eat well, time to do what is required to be healthy and rest well. Not meeting targets for the NHS could be equated to us individually having our own health program to which we follow to keep us on track and support our health and actually following advice and guidance from health professionals from appointments or make available publicly and so on.

    We are very good at blaming and criticising others and organisations when we do not live by the quality and actions that we ask and seem to expect of others. Time to take responsibility.

  26. Many people misuse the health service, especially when they want to get fixed, I have found that by taking responsibility for my own choices, making changes to the way I live, and being honest with myself has helped me realise that we can’t expect the health care system to just fix us, because we have to take responsibility first, and then seek help when we need it.

  27. 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.

  28. 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?

  29. 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.

  30. 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.

  31. 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.

  32. 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.

  33. 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.

  34. 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.

  35. 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.

  36. “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.

  37. 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.

  38. 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?

  39. 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.

  40. 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?

  41. 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.

  42. 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.

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