CMAJ: Are we betting on the welfare of our patients?

This week’s editorial in the Canadian Medical Association Journal may have raised the eyebrows of some hospital CEOs.

John Fletcher raises a question we asked more than year ago – does the duty to first ‘do no harm’ apply to gambling meant to support public services?

In February 2012 we questioned the role Susan Pigott (VP at the Centre for Addiction and Mental Health) played in the recommendations made by the Drummond Commission to increase access to gambling in Ontario. The recommendation was one of many by the Commission that appears to throw the well-being of citizens overboard to shore up government finances.

How different is it for hospitals to do the same, given hospital lotteries have become so ubiquitous in Ontario? The CMAJ says it is contradictory to ban hospitals from selling tobacco while allowing them to promote another addictive habit – gambling.

Fletcher does say the CMAJ doesn’t know if hospital lotteries are “really addictive and potentially ruinous” to some players and their families.

“Should we not be sure if we are to bet the welfare of our patients and their loved ones on the assumption that lotteries are harmless?” he asks.

Rather than scrap their lotteries, the CMAJ challenges hospitals to lead the way in showing us how to run ethical lotteries. That could include limiting the amount spent and banning bulk discounts.

The CMAJ doesn’t finger any specific hospital lottery. However, they could likely include the Princess Margaret lottery that sells $100 tickets but encourages purchasers to get five for $375 or The Hospital for Sick Kids, which suggests you can buy a $100 ticket or get 30 for $900. When we start talking about $900, this is no longer just a casual bet for most of us.