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Ethics in Cardiothoracic Surgery

A Clash of Rights: Should Smoking Tobacco Products in Public Places be Legally Banned?

^a Arkansas Department of Health, Tobacco Prevention and Cessation Branch, Little Rock, Arkansas
^b The Dr Patricia A. Hayes Professor in Applied Ethics, Department of Philosophy, St. Edward's University, Austin, Texas
^c Department of Surgery and the Institute of Human Values in Health Care, Medical University of South Carolina, Charleston, South Carolina

^_* Address correspondence to Dr Sade, Department of Surgery, 96 Jonathan Lucas St, Suite 409, PO Box 250612, Charleston, SC 29425 (Email: sader@musc.edu).

Presented at the Fifty-Fourth Annual Meeting of the Southern Thoracic Surgical Association, Bonita Springs, FL, Nov 7–10, 2007.

The first 300 words of the full text of this article appear below.

	Introduction

 
Robert M. Sade, MD
There is little question that smoking tobacco products is an important contributor to the development of many kinds of cancer, as well as to morbidity through its effects on lungs, blood vessels, and other vital organs and processes. Virtually all thoracic surgeons advise their patients who smoke to stop smoking because of the risks it poses to health, both short-term and long-term. Yet, it is a valid question to ask whether or not or to what extent these medical facts constitute justification of coercive action against smokers through enactment of laws.

There seems to be strong sentiment among thoracic surgeons in support of such laws, probably driven largely by their personal experiences with the pathology that smoking visits on those who are exposed to it. They are not as vocal, however, about the need for laws to control other destructive habits, such as eating too much (obesity is also a major cause of morbidity) or drinking too much (prohibition of alcohol early in the last century was not notably successful in reducing the damage caused by drinking, and was eventually repealed).

Much discussion in the popular media and medical literature has focused on what might be gained by legal prohibition of smoking in public places, but relatively little discussion has focused on what might be lost by enacting such laws. To put the arguments of both sides of this issue on the table for our inspection and thoughtful consideration, we present the case of a conflicted legislator who is also a thoracic surgeon.

The Case of the Ambivalent Surgeon
Dr Thomas Brady, a thoracic surgeon, has never had strong political inclinations, but he is very concerned that politicians seem to have little appreciation of the complexities of the contemporary healthcare system. In a moment of what he would have considered lunacy when he was younger, he . . . [Full Text of this Article]

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