Ethics of limb allografts

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7353.1585 (Published 29 June 2002) Cite this as: BMJ 2002;324:1585

Authors assume that they understand more than their patients do

  1. Kenneth J Mukamal (kmukamal@caregroup.harvard.edu), assistant professor of medicine
  1. Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
  2. Philosophy Department, University of Cape Town, Private Bag, Rondebosch 7700, South Africa
  3. Department of Plastic and Reconstructive Surgery, University of Cape Town, Observatory 7925, South Africa

    EDITOR—The term paternalism does not appear in the case descriptions by Benatar and Hudson, but it factors heavily in their discussion.1 The relative risks and merits of the proposed procedures are discussed from their viewpoint; the patient's (or parent's) insight is totally lacking. The fact that informed consent is not a perfect process is an unacceptable excuse for their decision to ignore the process. Such logic would suggest that we abandon informed consent altogether until it is perfected.

    Every surgical procedure has associated risks and benefits; we should quantify them to the greatest degree possible and then work with our patients to match their beliefs and preferences with those risks and benefits.

    The authors assume that they understand the risks and benefits of such a procedure with far more certainty than is justified. For example, they conclude that amputation among children …

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