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Unnecessary surgery and medical malpractice

What does an average patient think when their doctor recommends surgery? They likely think that extensive research has proven that surgery is beneficial for patients in their position. They assume that evidence has been gathered and rigorous scientific analysis has been conducted. After all, surgery, even minor surgery, carries serious risks. Would doctors really recommend a risky procedure without proof that it is effective?

As it turns out, yes, many doctors recommend surgeries that have scant evidence of effectiveness. Recent research into the ethically questionable practice of sham surgeries suggests that surgery in many cases is no more effective than the belief that surgery has been performed.

What is a sham surgery?

A research group is separated into two categories, those who will undergo a particular procedure and those who will be led to believe they received that same treatment. Patients who receive the sham surgery are put through all the same procedures that occur before and after a real surgery. They are even given the same incisions into their skin to leave convincing scars. They just don't receive the actual surgical procedure. The sham surgery serves the same role as a placebo in pharmaceutical trials.

The research

The people who received the surgery and those who received the sham surgery were surveyed regarding things like pain reduction. Perhaps the most common procedure involved in the sham surgery research was arthroscopic knee surgery used to fix a meniscus suffered from degeneration due to wear and tear. The research showed that the sham surgery was just as effective as the real surgery in these cases. Basically, a surgery performed hundreds of thousands of times a year does not appear to provide any actually benefits.

The placebo effect

Sham surgeries provide an extreme example of the placebo effect. A patient who believes a treatment will be effective is more likely to report the positive effects the treatment is said to provide. The more the patient is put through, the more likely he or she is to report benefiting from the treatment. In other words, something like swallowing a pill produces a milder placebo effect than getting a shot. Surgery, given the elaborate requirements and resulting pain, produces a very strong placebo effect. Because surgery is so dangerous and stressful, patients will report positive effects even when the procedure didn't actually help them at all. 

The reality is that doctors recommending surgery are often doing so on little to no evidence that the procedure works. Even reports that other patients felt better afterwards are not real evidence. Given the potential harm that a patient undergoing surgery is exposed to, physicians should be more careful in recommending that course of treatment.

Patient rights

Before performing a surgical procedure on a patient, doctors must obtain informed consent. For a patient's consent to truly be informed, he or she must be made aware of the risks of surgery, the potential benefits and any available alternatives. Physicians are required to disclose all known, material information about the surgery that would be significant to a reasonable person in deciding whether or not to consent to the surgery. Patients should not be led blindly into any surgical procedure.

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