The man, 56, is thought to be the first person to die since Australian doctors decided to take a stand on smokers and their treatment which, critics say, borders on “moral fascism”.

Some doctors have refused to perform transplants and other life-saving operations on smokers on “medical and moral” grounds.

But the doctors defended their position, saying that transplant organs are a very limited resource. “We have a very strict policy that we do not offer lung transplantations to people who smoke or have any other substance abuse in the last six months,” said Dr Greg Snell, a respiratory surgeon at Melbourne’s Alfred Hospital.

’Unconscionable’

The Australian Medical Association, which represents doctors, said treatment decisions should not be based on moral arguments. “It is unconscionable. We cannot judge our patients in that way,” said Dr Michael Sedgely of the AMA.

There have also been accusations that surgery bans have been imposed on fat people and drinkers and that sports injuries could be next, because of the person’s choice to take part in risky activities.

The man who died had been scehduled for a heart valve operation two days before Christmas. “He was shaved, he was ready, he was in his bed and the specialist came back and said ‘You haven’t given up smoking’ ,” said his daughter.

Playing God

He finally went in for his operation last Friday but didn’t survive. “His lungs weren’t strong enough,” she said.

The AMA’s president Dr Kerryn Phelps defended the right to refuse non-emergency surgery to smokers, saying a cash-strapped health industry had no choice but to refuse treatment in such cases.

Smokers accuse the doctors of playing God and say they pay enough tax on cigarettes to warrant tax-funded surgery.