Cigarette Smoking: How Much Worse Can It Get?
To the Editor:
I was delighted to read Dr Califf’s recent editorial.1 What made it so special wasn’t just the scientific part of the editorial, but Dr Califf’s discussion of the equally important (if not most important) ingredient that transforms an ordinary, or even an extraordinary, individual with an MD degree into a physician, and this is the humanity and ethics of medicine.
Dr Califf is absolutely correct when he points out the inhumane attitude of some MDs toward the ordinary human frailties of many of our patients. This is a new phenomenon, where doctors blame the patients for their ills and seriously consider not treating them. The patients who suffer the most from this attitude are the socioeconomically deprived members of our society (the elderly, minorities, and the poor).2 Having a patient choose between spending limited funds at a fast food place for high-calorie sustaining meals for themselves or their children or paying for expensive medication is a no-contest choice.3 4 For someone to call such patients noncompliant and berate them is an inhumane act. Such an act is grossly immoral and cruel by any healthcare provider, especially one with an MD degree.
- Copyright © 2001 by American Heart Association
Califf RM. Cigarette smoking: how much worse can it get? Circulation. 2000;102:1340–1341.
Rathore SS, Berger AK, Weinfurt KP, et al. Race, sex, poverty and the medical treatment of acute myocardial infarction in the elderly. Circulation. 2000;102:642–648.
Kasiske BL, Cohen D, Lucey MR, et al. Payment of immunosuppression after organ transplantation. JAMA. 2000;283.2445–2450.