Wensgeneeskunde: worden dokters nu verkopers?

Wish-fulfilling medicine – the use of medical technology for the prima facie non-medical wish of the patient – occurs in practice, both in and outside the Netherlands. In a recent study both GPs and plastic surgeons recalled occasions when they had fulfilled patient’s non-medical wish, sometimes against their own better judgement. The question is whether this is turning physicians into salesmen? The central values of medical professional ethics, namely autonomy, non-maleficence, beneficence, and justice still appear to play a central role. Neither physicians nor lay persons view physicians as salesmen. However, it appears that the balance between the importance attached to a well-considered wish of a patient and the associated risks and harms is shifting. Thus, a physician may well perform wish-fulfilling requests and still remain a good physician. However, there is certainly room for refusal.

Conflict of interest and financial support: disclosure forms provided by the author are available along with the full text of this article at www.ntvg.nl, search for A7507; click on ‘Belangenverstrengeling’ (‘Conflict of interest’).