On the Ethical Issues of Bilateral and Contralateral Risk-Reducing Mastectomy

Abstract

The principles of beneficence and patient autonomy can clash in various ways; this is the case of bilateral risk-reducing (BRRM) and contralateral riskreducing mastectomy (CRRM). Mastectomy, however, is rarely treated as an ethical issue. The literature of BRRM and CRRM is dominated by the topic of riskassessment. In this chapter, we are going to analyze BRRM and CRRM from a moral point of view. We are going to argue that patients' autonomy and women's self-determination over their own bodies can be considered as an indication of riskreducing mastectomies.

Basic psychological needs: A framework for understanding childbirth satisfaction

“…The need for autonomy is also frustrated when women are not adequately involved in decision-making about their own care, which is a distressingly common theme in birth stories. 34,41,67,68,69,97,124,127,129 In multiple countries, women's birth stories often include being ignored or over-ruled by hospital staff. 40,45,130 One woman described how she had to "argue" to receive an examination while she was in labor, while another wanted to be left alone but was pressured into having her water broken.…”

“…The need for autonomy is also frustrated when women are not adequately involved in decision‐making about their own care, which is a distressingly common theme in birth stories 34,41,67,68,69,97,124,127,129 . In multiple countries, women's birth stories often include being ignored or over‐ruled by hospital staff 40,45,130 .…”

“…Just searching 2013–2023, the phrase “childbirth satisfaction” appears in the title of over 1500 papers on Google Scholar. The few dozen referenced here are representative and recent selections, and they represent a variety of countries and cultures, for example, 64 (Turkey) 40 ; (the UK) 65 ; (Iceland) 66 ; (Pakistan) 67 ; (the United States) 68 ; (the Netherlands) 69 ; (Hungary) 34 ; (Australia) 45 ; (Norway).…”