Human Exceptionalism

Doctors Agree to Perform Medically Unncessary Amputation on Girl

This isn’t an BIID case, but it is disturbing nonetheless. A disabled girl wants her leg amputated so she can better engage in sports.  From the story:

A brave schoolgirl has decided to have her leg amputated–because she wants to become a world-class athlete. Danielle Bradshaw, 11, does not need to have her useless right leg removed but has chosen to go under the knife in a bid for sporting glory as a Paralympian. Danielle, from Newton in Hyde, has a healthy left leg but says she does not want to spend the rest of her life ‘dragging the other one’ behind her. Surgeons told her they could perform a number of operations and skin grafts on the limb, which has been damaged since birth.

They said the work would enable Danielle, a pupil at Flowery Field Primary in Hyde, to keep it but admitted that she would not be able to use it. Tired of repeated trips to hospital and having to watch her friends play out without her, and inspired by gold medals, Danielle stunned her parents by declaring she wants to have it amputated. They agreed and she will have the operation in Sheffield in August.

Amputation is very serious surgery.  It probably won’t–but could–kill her.  Is participating in sports really worth that risk? And if there are serious medical complications, will the parents blame themselves for going along or the doctors for agreeing?

That point aside, there is a lot to be said about this story–including the media’s boosting.  But here’s the bottom line: What does “harm,” as in “do no,” constitute today in the practice of medicine?  Increasingly, answers are not based on medical analysis but emotional narratives.  And that is reducing medicine from a profession into a technical trade.

Don’t get me wrong: I have great sympathy for this girl’s desire to be able to play and participate in sports.  Still, it seems to me that doctors should refuse to perform a medically unnecessary amputation.   That doctors have agreed, even though it isn’t being done to improve her health, is another small crack in the foundation of medical professionalization.

Update: The more I think about this, and from the reactions to the post so far, the more I see it as a crucial issue to ponder.  When do we need professional standards most?  In the tough cases.  And this is a very tough case.  A little girl wants to be able to play and compete.  But she is too young to really make an informed decision and cannot weigh and measure in the way that consenting to surgery requires.  Her parents, deeply yearn for that too, and quite understandably are very emotionally involved here.  But the remedy is a very serious surgery that could kill her, cause blood clots, permanent unconsciousness from an anesthesia side effect, etc.  That’s when doctors need to be professionals and provide a fail safe, rather than being an order taker.  So what is harm in this case?  A girl living with a disability or the potential terrible consequences if something goes wrong?  It is worth thinking very deeply about, I think.