Surgical Prophylactics for Ovarian Cancer (SPOC): An Ethical Inquiry
During the 1950's, the principle of Totality emerged as an important tool in medical ethics for evaluating the appropriateness of surgical mutilation. One of the early issues ethicists used the principle to address was prophylactic surgery, usually elective tonsillectomies and elective or incidental appendectomies. An ethical consensus emerged that, while neither an elective tonsillectomy nor an elective appendectomy was justified, an incidental appendectomy was pennissible. A directive allowing the latter can be found in the 1954 Code of Medical Ethics for Catholic Hospitals, I the forerunner of the present day Ethical and Religious Directives for Catholic Health Services. Since that time, discussions of prophylactic surgery have all but disappeared from the ethical literature, and no subsequent editions of the ERD contain any directive on the topic. Today, the issue of prophylactic surgery is once again emerging as a topic among ethicists and medical staff. The discovery that female carriers of BRCAJ and BRCA2 genn-line mutation may be at greater risk for breast and ovarian cancer2 has some physicians and women questioning whether prophylactic surgery to reduce that risk, specifically a mastectomy or a tubal ligation, can be ethically