The Ethics of Smoking presentation PMA convention 2022

Presented to the members of the Philippine Medical Association in 2022

1. The Ethics of Smoking
Guia Crisostomo Tan, MD, MS Bioethics
Ethics Subject Expert, Ateneo School of Medicine and Public Health
Chair, Formation Cluster, Ateneo School of Medicine and Public Health

2. NO
REDEEMING
VALUE
pic: https://i.pinimg.com/474x/a5/95/59/a595596acc7b7e4f43a060bda4bfe709--anti-
smoking-the-temple.jpg

3. Pic: https://aboutcagayandeoro.com/wp-content/uploads/2016/11/cigarette-graphic-health-warning.jpg

4. •Linked to 25 diseases that shorten lifespans
•Addicting
•Steals from income that could be used for education, health, nutrition, clothing
•Detrimental to health of fetuses
•Second hand smoke effects on non-smokers
pic:https://cdn.craigdailypress.com/wp-content/uploads/sites/10/2019/04/native-cdp-040519-2-1024x951.jpgpic:https://d1pz9rwztkrv8y.cloudfront.net/media/images/WHO-Graphics_2019_Lifetime-Impacts_V2.width-960.png
HARMS FROM SMOKING
ENVIRONMENTAL EFFECTS

5. Pic: https://scx2.b-cdn.net/gfx/news/hires/2012/42-researchersf.jpg
Pleasurable
MEMORY
ATTENTION
SPATIAL
VISUAL
ORIENTATION
Great Social Experience!

6. Should Smoking be
Discouraged?
Benefits
•Pleasure
•Clarity in thought
•Anxiety-lowering
•Fosters social tiesHarms
•Illnesses
•Decreased life spans
•Addictive
•Misallocation of
personal resources
•Low birth weight of
children
•Second hand smoke
•Environmental harm

7. SHOULD SMOKING BE DISCOURAGED?
YES
NOGovernments
WHO
Health Care
workers
Non-smokers
Pregnant
Children
Ecologists
Smokers
Libertarians
WHO, 2008

8. SHOULD SMOKING BEDISCOURAGED?
YES
NO

9. SHOULD SMOKING BE STOPPED?
YES
NO

10. TOO
EXTREME
!!!
YESNO
Some Health
Care workers
Some
Governments
Pregnant
Children
Ecologists
WHO
Smokers
Libertarians
Some HCW
Some Govts
SHOULD SMOKING BE STOPPED?
AUTONOMYPUBLIC GOOD

11. YESNO
SHOULD SMOKING BE STOPPED?
AUTONOMYPUBLIC GOOD
LET D.O.H. DECIDE

12. “Mandate a “smoker’s license” forthose who
want to smoke.”
•The license can only be obtained starting age 21.
•The license would be expensive to acquire
•The license would need to be renewed yearly and would require a yearly payment.
•The payments for the license would be channeled to the health care budget
Haliday, D. “The Ethics of a Smoking Licence.”
J Med Ethics 2016; 42: 278-284
Pic:https://www.puffcity.com/wp-content/uploads/2019/06/License-To-
Open-A-Smoke-Shop.jpg

13. Include in the Physician Code of Ethics a statement
that would regard smoking as a grave violation of
right conduct expected of a physician.
Appel, J. “Smokes & Mirrors: One case for ethical obligations of the Physician as a Public
Role Model.” Cambridge Quarterly of Healthcare Ethics (2009), 18, 95–100
https://p1-tt.byteimg.com/origin/tos-cn-i-
qvj2lq49k0/5e6a3c445b774ad8842a579bad09946a.jpg
Why do doctors
persuade others to
quit but they keep
smoking?

14. Do a total smoking ban in the Philippines
similar to what New Zealand is doing
;pic: https://encrypted-
tbn0.gstatic.com/images?q=tbn:ANd9GcTWFFnAGqTRuJ
sF75K60hJ2upcWTUsccKiu5Q&usqp=CAU

15. Which among the 3 proposals presented
would you most likely support?
A –SMOKING LICENSE
B –INCLUSION OF A PROHIBITION AGAINST SMOKING FOR PHYSICIANS IN THE CODE OF ETHICS
C –TOTAL NATIONWIDE BAN ON SMOKING
D –NONE OF THE ABOVE
E --OTHER
Smoking is a social ill that impacts negatively on the growth of a
country and should be addressed.
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16. The Ethics of Smoking
•Smoking: Harms >>> Good (protection of an individual’s Autonomy)
•Autonomy has limits when it does harm to self and to others
•“MPOWER” : regulation on a Smoker’s Autonomy
•Several measures proposed to further regulate the autonomy of
smokers –smoking licence, regulate physician smoking, total ban
•Drastic measures supported by UTILITY & NON-MALEFICENCE
•Shouldn’t NON-MALEFICENCEalways TRUMP AUTONOMY?