The physician as wish doctor

Xavier Symons
2 Nov 2013
Reproduced with Permission

Since the Hippocratic oath the role ascribed to a doctor has been that of healer. However, new developments in medicine are adding an additional role for the doctor: wish-fulfilment.

Doctors today perform a wide variety of procedures that are strictly speaking not treatments for illness - cosmetic surgery, testosterone therapy, vasectomies, whole body scans (and some would even euthanasia and abortion to the list). Many of these procedures fall under the category of 'human enhancement' - they are a kind of wish-fulfilment.

A number of recent articles in the Journal of Medical Ethics report what both doctors and lay people think of wish-fulfillment medicine.

In one paper, 21 GPs and plastic surgeons were interviewed. The interviewees had few scruples about the changing role of the doctor, nor were they concerned about reinforcing negative social norms about the body. Their concerns were more practical - the potential side-effects of the treatment, and the possibility that a patient may have some underlying psychological illness.

There was less consistency in the response of lay people. 37 people from outside the medical sector were interviewed, (from a range of socio-cultural groups).

The participants expressed conflicting views about the different kinds of wish-fulfilment medicine. Many feared that women seeking breast implants had underlying psychological issues: "[an implant] doesn't solve it, you need to search for the underlying cause", insisted one participant.

Similarly, when asked about egg freezing, respondents were critical: "If you don't find the partner [in time] then that is how it is."

They were however, committed to a more general principle of autonomy: "In general I think therefore that a person themselves may do what one want with his or her body" said one respondent, echoing the sentiments of the others.