title: Wish-fulfilling medicine in practice: the opinions and arguments of lay people.
abstract: BACKGROUND
  Wish-fulfilling medicine appears to be on the rise. It can be defined as 'doctors and other health professionals using medical means (medical technology, drugs, and so on) in a medical setting to fulfil the explicitly stated, prima facie non-medical wish of a patient'. Some instances of wish fulfilling medicine can be understood as 'human enhancements'.
  
  
  OBJECTIVE
  The aim of this study is to map the normative opinions and arguments of lay people about wish-fulfilling medicine.
  
  
  METHODS
  We conducted a qualitative study with lay people (five focus groups). We asked their opinions about five cases and the arguments for these opinions. Furthermore, we enquired about the role of the medical profession and the treating physician, and whether the participants saw a role for the government.
  
  
  RESULTS
  The opinions and arguments used varied according to the example discussed. For instance, increased familiarity with a procedure like breast enhancement seems to garner more acceptance for that procedure, whereas completely new examples were considered less acceptable. Various different arguments were raised in focus groups; these included: people should be allowed to make up their own minds about this (autonomy); payment of the treatment; and concerns about risks.
  
  
  CONCLUSIONS
  An ethical analysis of the emerging practice of wish-fulfilling medicine should take the normative views of all parties involved into account. Thus, it is important to establish what lay people think about wish-fulfilling medicine and in particular their arguments.
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, ErasmusMC, Rotterdam, The Netherlands.
authors.forename: Eva C A
authors.initials: EC
authors.lastname: Asscher
authors.affiliation: Department of Medical Ethics and Philosophy of Medicine, ErasmusMC, Rotterdam, The Netherlands.
authors.forename: Maartje
authors.initials: M
authors.lastname: Schermer
mesh_terms: D000328:Adult; D000368:Aged; D001290:Attitude; D024803:Biomedical Enhancement / Q000941:ethics*; D003357:Cosmetic Techniques / Q000941:ethics* / Q000523:psychology; D026689:Ethical Analysis; D005260:Female; D017144:Focus Groups; D005102:Health Expenditures / Q000941:ethics*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D061214:Patient Safety; D018802:Patient-Centered Care / Q000941:ethics*; D010361:Patients / Q000523:psychology*; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D036301:Qualitative Research; D011795:Surveys and Questionnaires
keywords: Enhancement; Paternalism; Professional - Professional Relationship