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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
Competing interests:
No competing interests
13 October 2008
Umo I Esen
Consultant Obstetrician and Gynaecologist
South Tyneside NHS Foundation Trust,Harton Lane South Shields, NE34 OPL
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
Competing interests: No competing interests