澳医院拒绝给吸烟者做心肺移植手术
路透社墨尔本健康消息 据澳州《时代日报》和其它媒体报导，澳洲阿尔弗雷德医院的外科医生要求病人在接受心肺移植手术前必须戒烟。该项命令在澳大利亚引起了激烈的争论。
该医院的声明说，由于供体严重不足，医生要尽可能保证每一份来自器官捐赠者的“生命礼物”都能发挥最好的作用。要求心肺器官移植的受者戒烟，是为了最大程度地保证他们术后的康复并保持良好状态。声明还强调，阿尔弗雷德医院的选择标准和国际心肺移植学会公布的标准是一致的，该标准部份是与生活方式因素相关的，包括排除能明显增加移植术后严重并发症的风险因素，吸烟正是其中一项风险因素。
澳大利亚医学会维多利亚分会会长迈克尔·塞吉利博士说，做出这样的决定是基于充足合理的医学理由，不是仅仅为了让病人戒烟。 对于接受心肺移植的病人来说，吸烟者的预后效果是比不上不吸烟者的。医生不能禁止病人吸烟，但应考虑吸烟病人的治疗效果。
墨尔本皇家理工学院的医学伦理学家麦根-简·约翰斯通教授则认为吸烟是一种成瘾状态，大众认为吸烟是可以接受的行为。他在接受采访时说：“难道我们可以不治疗自杀未遂者和酗酒者吗？我相信五、六十年前医生还将吸烟作为缓解压力的治疗手段。现在武断地拒绝病人接受心肺移植手术是用临床判断来伪装伦理。”他还说：“高明的医生并非伦理学家，这是一个复杂的问题，想简单解决也存在困难，这需要广泛的磋商，包括听取医疗保健消费者的意见。”
, http://www.100md.com
Smokers Denied Transplants at Australian Hospital
MELBOURNE (Reuters Health) - Surgeons at The Alfred Hospital here are demanding that smokers stop the habit before undergoing major heart and lung surgery, according to a report by the Australian daily newspaper The Age and other media services. The reported ban has raised a storm of controversy in Australia.
The hospital says asking lung and heart transplant recipients to give up smoking is done as a way to define who is most likely to do well after a transplant.
, 百拇医药
``The scarcity of organ availability obliges the Hospital to ensure that the best outcome from the ‘gift of life‘ of an organ donation occurs,‘‘ according to a statement from the hospital.
``The Alfred‘s selection criteria is consistent with the published policy of the International Society of Heart and Lung Transplantation. These criteria in part relate to lifestyle factors, which will seriously increase the risk of serious post-transplant complications. Smoking is clearly one of these factors,‘‘ according to the statement.
, 百拇医药
Dr. Michael Sedgley, president of the Australian Medical Association‘s Victorian branch, told Reuters Health, ``We can‘t make blanket statements about people who smoke and how we will or will not treat them. However, as far as heart-lung transplants are concerned, it‘s blatantly obvious that a smoker will not do as well as someone who doesn‘t (smoke).‘‘
Sedgley added that ``such judgments must be made for sound medical reasons, not judging somebody for not giving up smoking.‘‘
, 百拇医药
But Professor Megan-Jane Johnstone, a health ethicist at the Royal Melbourne Institute of Technology, told Reuters Health that ‘‘smoking is an addiction, in a cultural climate of fierce publicity and indoctrination about the kudos of being a smoker.‘‘
Johnstone added, ``Should we not treat suicide victims or those who over-use alcohol? I believe that 50 or 60 years ago doctors prescribed smoking as a treatment for stress. Patients arbitrarily being denied treatment is ethics masquerading(伪装，冒充)as clinical judgments.‘“我们难道
Professor Johnstone commented to Reuters Health that ‘‘competent surgeons are not ethicists. This is a complex issue and to deal with it simplistically is problematic. There needs to be wide consultation, including with healthcare consumers.‘‘
The Alfred has refused further comment., http://www.100md.com
该医院的声明说，由于供体严重不足，医生要尽可能保证每一份来自器官捐赠者的“生命礼物”都能发挥最好的作用。要求心肺器官移植的受者戒烟，是为了最大程度地保证他们术后的康复并保持良好状态。声明还强调，阿尔弗雷德医院的选择标准和国际心肺移植学会公布的标准是一致的，该标准部份是与生活方式因素相关的，包括排除能明显增加移植术后严重并发症的风险因素，吸烟正是其中一项风险因素。
澳大利亚医学会维多利亚分会会长迈克尔·塞吉利博士说，做出这样的决定是基于充足合理的医学理由，不是仅仅为了让病人戒烟。 对于接受心肺移植的病人来说，吸烟者的预后效果是比不上不吸烟者的。医生不能禁止病人吸烟，但应考虑吸烟病人的治疗效果。
墨尔本皇家理工学院的医学伦理学家麦根-简·约翰斯通教授则认为吸烟是一种成瘾状态，大众认为吸烟是可以接受的行为。他在接受采访时说：“难道我们可以不治疗自杀未遂者和酗酒者吗？我相信五、六十年前医生还将吸烟作为缓解压力的治疗手段。现在武断地拒绝病人接受心肺移植手术是用临床判断来伪装伦理。”他还说：“高明的医生并非伦理学家，这是一个复杂的问题，想简单解决也存在困难，这需要广泛的磋商，包括听取医疗保健消费者的意见。”
, http://www.100md.com
Smokers Denied Transplants at Australian Hospital
MELBOURNE (Reuters Health) - Surgeons at The Alfred Hospital here are demanding that smokers stop the habit before undergoing major heart and lung surgery, according to a report by the Australian daily newspaper The Age and other media services. The reported ban has raised a storm of controversy in Australia.
The hospital says asking lung and heart transplant recipients to give up smoking is done as a way to define who is most likely to do well after a transplant.
, 百拇医药
``The scarcity of organ availability obliges the Hospital to ensure that the best outcome from the ‘gift of life‘ of an organ donation occurs,‘‘ according to a statement from the hospital.
``The Alfred‘s selection criteria is consistent with the published policy of the International Society of Heart and Lung Transplantation. These criteria in part relate to lifestyle factors, which will seriously increase the risk of serious post-transplant complications. Smoking is clearly one of these factors,‘‘ according to the statement.
, 百拇医药
Dr. Michael Sedgley, president of the Australian Medical Association‘s Victorian branch, told Reuters Health, ``We can‘t make blanket statements about people who smoke and how we will or will not treat them. However, as far as heart-lung transplants are concerned, it‘s blatantly obvious that a smoker will not do as well as someone who doesn‘t (smoke).‘‘
Sedgley added that ``such judgments must be made for sound medical reasons, not judging somebody for not giving up smoking.‘‘
, 百拇医药
But Professor Megan-Jane Johnstone, a health ethicist at the Royal Melbourne Institute of Technology, told Reuters Health that ‘‘smoking is an addiction, in a cultural climate of fierce publicity and indoctrination about the kudos of being a smoker.‘‘
Johnstone added, ``Should we not treat suicide victims or those who over-use alcohol? I believe that 50 or 60 years ago doctors prescribed smoking as a treatment for stress. Patients arbitrarily being denied treatment is ethics masquerading(伪装，冒充)as clinical judgments.‘“我们难道
Professor Johnstone commented to Reuters Health that ‘‘competent surgeons are not ethicists. This is a complex issue and to deal with it simplistically is problematic. There needs to be wide consultation, including with healthcare consumers.‘‘
The Alfred has refused further comment., http://www.100md.com