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Doctors' human rights and the smoking ban

Published online by Cambridge University Press:  02 January 2018

Asad Raffi
Affiliation:
Mersey Care NHS Trust, Broadoak Unit, Thomas Drive, Liverpool, Merseyside L14 3PJ, email: asad.raffi@merseycare.nhs.uk
Jahangir Mahmood
Affiliation:
Mersey Care NHS Trust
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Abstract

Type
The columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2009

Mental health trusts across the UK have implemented a smoke-free agenda that the National Health Service in England and Wales will be smoke-free by December 2006. 1 ‘Smoke-free’ means that smoking will not be permitted anywhere within hospital grounds, with no exceptions for staff or visitors and limited exemptions for certain patients, providing no one is subject to passive smoking as a result. Reference O'Gara and McIvor2 Although this is acceptable in order to maintain government legislation on smoking in public places, one has to ask whether these rules should also apply to domiciliary visits?

If smoking by a service user, in their home, interferes with the doctor–patient consultation, then should the clinician be able to insist that the patient stop smoking, or is this a breach of their human rights? We have experience of domiciliary visits where the patient has insisted on smoking cigarettes during the consultation, despite requests to stop. As such visits may arise in the context of Mental Health Act assessments or urgent reviews, they may be perceived to be stressful by the patient, hence providing justification for smoking to relieve tension.

However, passive smoking is not only detrimental to the clinician's health. It may also have a negative impact on the therapeutic alliance, if the issue is confronted. And surely doctors’ human rights are just as important as patients’?

References

1 Department of Health. Annual Report of the Chief Medical Officer 2003. Department of Health, 2004.Google Scholar
2 O'Gara, C, McIvor, R. Smoke-free psychiatric services. Psychiatr Bull 2006; 30: 241–2.Google Scholar
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