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OBSERVATIONS: Daniel K Sokol The harms of medicoplasty BMJ 2008; 337: a1983 [Full text]

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Patient request surgery

Umo I Esen   (13 October 2008)

Patient request surgery 13 October 2008
Umo I Esen, Consultant Obstetrician and Gynaecologist South Tyneside NHS Foundation Trust,Harton Lane South Shields, NE34 OPL Send response to journal: Re: Patient request surgery	The Editor, Patient request aesthetic vaginal surgery it would appear is a small but growing phenomenon , but the main problem lies within mainstream surgical procedures, where major surgical procedures are being requested by patients in the absence of clinical indications and where the risk benefit ratio is heavily weighed against the patient.(2) Sokol (1)makes the point that doctors are increasingly putting foward the argument of patient autonomy as the reason for agreeing to perform these procedures as requested by patients. Respect for patient autonomy, a corner stone of good medical practice is to be encouraged, in deed respect for patient autonomy must include dissuading patients from their autonomous choice if in light of the doctor’s experience, training, knowledge and skill the treatment requested is not in the patient's overall interest; if this is not the case then doctors run the risk of reducing their role in these situations largely to that of a technician who is there to carry out what ever the patient desires even if the patient is worse off following treatment. This scenario becomes of more concern where such surgery is being performed privately for a fee. Doctors must bring their knowledge to bear first of all, then their skills especially in patient request procedures whether aesthetic or not. To do otherwise is to abdicate their duty of care to the patient, and such abdication does not constitute respect for patient autonomy References. 1. Sokol D K. The harms of medicoplasty. BMJ 2008; 337: a1983 2. Esen U I , Archibong E I. Maternal request caesarean section: maternal vs medical autonomy. British Journal of Hospital Medicine. 2007, vol 68 . No 11. 610-611 Competing interests: None declared