Hospital lotteries are an area in which health professionals should take the lead in minimizing harm for those susceptible to problem gambling, a Canadian medical journal proposes.
Dr. John Fletcher, editor-in-chief of the Canadian Medical Association Journal, said in an editorial published Tuesday that it's contradictory that there is legislation to ban hospitals from selling one potentially harmful, but legal, addictive product on their premises — tobacco — while hospitals can actively promote another — lotteries.
Lotteries use ads and websites offering prizes such as houses, cars, trips and cash to raise $10 million or more a year for research and teaching at larger hospitals and close to $1 million at smaller hospitals, Fletcher says.
The lotteries are based on the assumption that the games of chance are harmless but no one really knows, he says.
"Have we lost our moral compass to such an extent that we are blinded to our duty to 'first do no harm' by the attraction of easy revenue?" Fletcher asks.
"Hospitals should be leading the way to develop responsible lotteries that protect the vulnerable and minimize the potential harms associated with gambling; they should be at the forefront of research to identify and mitigate harm."
In 2004, Robert Williams of the Alberta Gambling Research Institute, using data from eight provinces estimated that 4.2 per cent of Canadians were problem gamblers accounting for 23.1 per cent of gambling revenue.
"Hospitals might even increase their revenues by caring for their lottery customers," Fletcher suggested. "For many people, purchasing a lottery ticket is a bit of fun made all the better when it is for a good cause. For others, it is a ticket on a journey of misery, marital breakdown and mental illness. As good corporate citizens, hospitals should show Canada what it means to run ethical lotteries."
To protect vulnerable players, the editorial recommends that hospitals:
- Require personal identification.
- Ask players to specify personal spending limits in advance, an option in the UK's national lottery.
- Limit the amount that can be spent and stop offering discounts for multiple ticket purchases.
The Princess Margaret Cancer Centre is part of Toronto's University Health Network. The hospital runs a lottery that gives people a chance to win houses, cars, trips and cash prizes worth millions of dollars in total.
Dr. Robert Bell, president and CEO of University Health Network, said a 2011 Swedish study of different forms of gambling found lotteries were far less hazardous to at-risk and problem gamblers than other games of chance, such as interactive internet gambling and casino gambling.
"So I think … the form of gambling we're talking about — that is, lotteries — is the least associated with problem gambling," Bell said.
"And, of course, the hospital lotteries do a tremendous amount of good in providing funding for enhancing patient care and certainly funding crucial research — funding that is difficult to raise in other ways."
Lotteries were illegal in Canada until 1969.