Doctors have no 'mandate' to decide on moral grounds how health services are to be rationed.
According to the reported comments, the moral justification is said to be that to provide medical treatment to a smoker consumes scarce resources for the benefit of someone 'who is contributing to their own demise'. But it would represent a fundamental change in health policy if health services were to be denied to those who 'contribute to their own demise'. A change of that kind is a matter for the legislature, after full community debate, not for individual doctors or hospitals. In any case, there are obvious difficulties in developing any coherent policy of that kind. We recognise that the position is quite different if the patient's smoking history means that the proposed operation is too dangerous or has poor prospects of success.