40 per cent of Dutch doctors: patients with unhealthy lifestyles should not always get care

According to a survey of 1.500 medical specialists, roughly 40 per cent would support a policy allowing them to refuse non-emergency treatment to patients whose unhealthy lifestyles had made them ill.

Slightly fewer - around 30 per cent - believe they would actually make use of such an option.

The study was undertaken by broadcaster KRO-NCRV, for the television programme Brandpunt, in collaboration with the Federation of Medical Specialists.

A need for sustainable change

The survey comes at a time when rising healthcare costs are a point of concern for observers inside and outside the medical profession.

Healthcare is, on the one hand, much more effective at increasing life span and quality than ever before, with a wealth of new means available to manage and cure diseases. But these new medicines and treatments are also becoming increasingly expensive.

At the same time, like many other developed nations, the Netherlands is facing an aging baby-boomer population. Fearing crowded hospitals and an over-taxing of the healthcare system, experts are seeking ways to make public healthcare sustainable.

Education as health care strategy

Cardiologist and Federation of Medical Specialists director, Marcel Daniels, does not view the survey results as showing a lack of concern on the part of doctors. Rather, he sees a broadening of perspective on what constitutes medical care.

"It is an important sign that doctors are not only focused on intervention," he says. "They really want to make people better, and there is more to that than operation or treatment."

According to the study, the vast majority of Dutch doctors view education as a crucial component of healthcare.

Many consider informing patients about the consequences of unhealthy lifestyle choices to be an integral part of their work.

Whereas 37 per cent of specialists surveyed believe denying treatment to patients with damaging habits will save costs, 68 per cent believe this can be achieved through reminding patients that their choices are unhealthy.

A full 80 per cent of doctors believe the government should do more to educate and encourage people when it comes to lifestyle health.

A political issue

Daniels asserts that the treatments in question do not include those necessary to save a patient’s life.

Still, the survey has generated debate. A major line of criticism revolves around how doctors would determine that the health issue really arose from the lifestyle habits of the patient, as well as how "free" patients really are to make healthy choices.

Medical ethicist Medard Hilhorst warns in Trouw that such a policy would have strong political implications: "There are always hereditary influences. There are social components: people with low incomes often live less healthily. Do you have to deny them treatment?".

At the same time, he says, even if a policy allowing doctors to deny patients treatment on the basis of their lifestyles were adopted, it would not lead to doctors turning people away constantly.

Emily McCallum


Emily McCallum

Emily grew up in a small coastal town in western Canada and moved to Utrecht in 2014, after completing her studies in Vancouver and Germany. So far, she has been...

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