Wednesday, July 04, 2007

Where is the line between common sense and excessive political correctness?

Also nothing to do with learning - it's one of those days!

Two things have contributed to my thoughts on this subject.

Firstly, on 1 July, a ban on smoking in public places and places of work was introduced right across Britain. That means, no smoking in pubs or restaurants and no huddling in the doorways of offices for a quick fag break. As an ex-smoker, and therefore more offended than most by secondhand smoke, I am delighted. However, one of the backlashes is that more people are now smoking as they walk along the road, which means I seem to be getting more frequently assailed.

On the other hand, one of the consequences of the ban is that shisha cafes are now having to close down. These are places where people go for the express purposes of smoking shisha through a hubble bubble pipe. Now I don't doubt that this practice is as bad for you as smoking cigarettes, but are we not removing people's freedom of choice (even stupid choices) if we ban these places. Tobacco is not illegal, smoking is not illegal. If a place exists purely for the practice of smoking a legal substance, surely everyone who goes there and who works there is aware of this (and probably a smoker themselves)? I wonder if this isn't taking it a bit far.

The second catalyst for this train of thought came from Artichoke's post today (I tried to comment, Arti - but it bombed me out several times, so I gave up). In it, she touches on the issue of preventable diseases, the treatment thereof and people's attitudes on the matter. This is a subject I've thought about before, too.

When George Best received a liver transplant, having destroyed his own through years of alcoholism, there was a general outcry. Doctors explained that he was selected on the basis of tissue compability, but I suspect that many remained convinced that other, less famous people on the list would have the same tissue type and would have made more worthy recipients. Certainly this view was expressed in my hearing on several occasions.

There are often references to the treatment of people suffering from self-inflicted conditions. With the NHS strapped for cash, I suppose the issue of prioritising is inevitably going to keep cropping up. But I wonder where the line is on self-inflicted conditions.

Years ago, I used to visit a young lad in hospital in Cape Town. He had been the South African junior trampolining champion and one day, he miscalculated, landed on his head and suffered a c2/3 fracture, resulting in paralysis from the neck down. Self-inflicted?

According to the staff there, statistically the most likely ward mates for this young man were young male rugby players aged between 18-24, playing forward positions. Newly endowed with the full body weight of an adult male and not yet possessed of the degree of self-preservation that came with age and maturity, these young men were at the greatest risk of suffering severe neck trauma. Self-inflicted?

If we were to get pedantic about it, aside from the ones that already rate a mention, such as obesity and smoking- and alcohol-related disorders, the following conditions are all avoidable and/or self-inflicted, too:

  • Injuries through accidents, negligence or recklessness
  • Sports injuries
  • Most cases of RSI
  • Pregnancy and childbirth
  • Sexually transmitted diseases
So where do we draw the line? And who gets to make the call? Often when I raise this subject, people say, "How would you feel if...?" And it's a line I have entertained myself. Make no mistake, I would be apoplectic if some overweight, alcoholic smoker got an organ transplant ahead of my husband or one of my sons. But surely that is not a reliable basis for a judgement in this situation? And if not, what is?

Oh, and just in the interests of full disclosure - my father was an alcoholic who climbed down the neck of a vodka bottle and never came back up, so I have some insight into the pain endured by the families of the "self-inflicters".

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