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?

 

References: 

  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 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790666/
  1. http://theconversation.com/lifestyle-diseases-make-global-health-promotion-more-difficult-than-ever-28074
  1. http://www.nhs.uk/NHSEngland/AboutNHSservices/doctors/Pages/expert-patients-programme.aspx
  1. http://www.dailymail.co.uk/news/article-2436944/NHS-bans-GPs-carrying-minor-operations-patients-smoke-unless-promise-quit.html
  1. http://www.telegraph.co.uk/health/9135184/Moral-judgments-about-treating-smokers-or-obese-patients-have-no-place-in-the-health-service.html
  1. Serge Benhayon (2011) Esoteric Teachings and Revelations: A new study for mankind. Unimed Publishing

 

 

 

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

  1. It appears from this article, and many others I have read, that not only is the NHS struggling to keep up financially and practically with the huge demand on its services, but so are many other health systems around the world. And then when I read the information from the WHO that a large percentage of all illnesses and disease are as a result of our life style choices, and so are preventable, it is clear that the majority of humanity are not taking responsibility for the way they live. Just imagine how quickly the health of the world would improve if each and every one of us began to take responsibility for all our choices instead of expecting someone else to fix us when we get sick.

  2. I personally do not feel that it is discriminatory to refuse to treat patients who will not make changes to stop harming themselves and feel that this is inevitably where we are heading. I realise that this is against everything that doctors are taught, but nevertheless I cannot see how we can avoid this as money runs out and we start to see that the annual bail outs we provide to the health services are no longer possible. In bankruptcy, difficult decisions will have to be made.

  3. The medical care systems of the world and the education systems need to meet up with government and begin introducing classes such as cooking and nutrition, gentle exercise, and general self care into schools. Cooking and nutrition classes alone from a young age could make a difference to obesity rates especially if it’s coupled with growing food as part of science classes. Some schools in Australia have already successfully trialled gardening and cooking for young children with a program called the “Kitchen Garden”. If we are coming out of the education system with no idea of how to take care of ourselves and ending up very unwell as adults what’s the point of the knowledge? I feel we need to partner education with caring for our health and wellbeing. This could help establish healthy lifestyle choices from a young age.

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