Abstract
Hysterectomy (or hysterectomy with oophorectomy) is the most frequently performed major surgery in the United States, affecting approximately 700,000 women each year (Easterday, 1983). There has long been interest in the psychological effects of these surgeries. However, apart from the concern that some hysterectomies may be unnecessary (Pearse, 1976), there has been little attention to bioethical issues relating to hysterectomy. Physicians and nurses are ethically obligated to respect the woman who may have a hysterectomy by treating her as an autonomous agent. Informed consent within the context of a decision for hysterectomy should include balanced information and supportive exploration of the woman's values, goals, and life plan. Care of the patient should assist her adjustment, thereby also promoting her autonomy. Physician attitudes toward hysterectomy and the hysterectomy patient can have a major influence on patient self-determination.
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References
Asch, R. and Greenblatt, R.: 1977, ‘Steroidogenesis in the Postmenopausal Ovary’, Clinical Obstetrics and Gynecology 4, 1, p. 85.
Barker, M. G.: 1968, ‘Psychiatric Illness after Hysterectomy’, British Medical Journal 2, pp. 91–95.
Boston Women's Health Book Collective: 1984, The New Our Bodies, Ourselves, Simon and Schuster, New York.
Budoff, P.: 1983, No More Hot Flashes and Other Good News, Putnam, New York.
Burchell, R.: 1977, ‘Decision Regarding Hysterectomy,’ American Journal of Obstetrics and Gynecology 127, 2, pp. 113–117.
Dalton, K.: 1957, ‘Discussion on the Aftermath of Hysterectomy and Oophorectomy,’ Section of General Practice, Proceedings of the Royal Society of Medicine 50, pp. 415–418.
Drew, N.: 1986, ‘Exclusion and Confirmation: A Phenomenology of Patients' experiences with caregivers,’ Image: Journal of Nursing Scholarship 18, 2, pp. 39–43.
Easterday, E. et al.: 1983, ‘Hysterectomy in the United States,’ Obstetrics and Gynecology 62, pp. 203–212.
Gadow, S.: 1980, ‘Existential Advocacy: Philosophical Foundation of Nursing,’ in S. F. Spicker and S. Gadow (eds.) Nursing Images and Ideals: Opening Dialogue with the Humanities, Springer, New York, pp. 79–101.
Gallo, D.: 1969, ‘Implications Sicologicas Relacionadas Con Histerectomia,’ Ginec. Obstet. Mexico, 26, pp. 437–444.
Gardner, D.: 1985, ‘Presence,’ in G. M. Bulechek and J. C. McCloskey (eds.) Nursing Interventions: Treatments for Nursing Diagnoses, W. B. Saunders, Philadelphia, pp. 316–327.
Gattegno, C.: 1985, ‘How Can Medicine be Open-Minded: An Experiment in Learning,’ Advances in Nursing Science 2, 4, pp. 61–66.
Hermann, B.: 1984, ‘Maturing Through Hysterectomy,’ Human Development 5, 2, pp. 18–22.
Kaltreider, N. et al.: 1979, ‘A Field Study of the Stress Response Syndrome: Young Women After Hysterectomy,’ Journal of the American Medical Association 242, 14, pp. 1499–1503.
Lalinec-Michaud, M. and Engelsmann, F.: 1984, ‘Depression and Hysterectomy: a prospective study,’ Psychosomatics 25, 7, pp. 550–558.
Lalinec-Michaud, M. and Engelsmann, F.: 1985, ‘Anxiety, Fears and Depression Related to Hysterectomy,’ Canadian Journal of Psychiatry 30, pp. 44–47.
Lennane, K. and Lennane, R.: 1973, ‘Alleged Psychogenic Disorders in Women — A Possible Manifestation of Sexual Prejudice,’ The New England Journal of Medicine 288, 6, pp. 288–292.
Levinson, C.: 1972, ‘Hysterectomy Complications,’ Clinical Obstetrics and Gynecology 15, pp. 802–826.
Lindemann, E.: ‘Observations on Psychological Sequelae to Surgical Operations in Women’, American Journal of Psychiatry 98, pp. 132–137.
Martin, R. et al.: 1980, ‘Psychiatric Status After Hysterectomy: A One-Year Prospective Follow-Up,’ Journal of the American Medical Association 244, pp. 350–353.
Melody, G. F.: 1962, ‘Depressive Reactions Following Hysterectomy,’ American Journal of Obstetrics and Gynecology 83, pp. 410–413.
Miller, B.: 1981, ‘Autonomy and the Refusal of Lifesaving Treatment,’ The Hastings Center Report, August, pp. 22–28.
Morgan, S.: 1978, ‘Sexuality After Hysterectomy and Castraction,’ Women Health 3, pp. 5–8.
Munnell, E.: 1947, ‘Total Hysterectomy,’ American Journal of Obstetrics and Gynecology 54, p. 31.
Neefus, M. and Taylor, M.: 1981, ‘Educational Needs of Hysterectomy Patients’, Patient Counseling and Health Education 3, 4 pp. 150–154.
Newton, N. and Baron, E.: 1976, ‘Reactions to Hysterectomy: Fact or Fiction,’ Primary Care 3, 4, pp. 781–801.
Notman, M.: 1979, ‘How Should You Advise Your Hysterectomy Patient,’ Modern Medicine February 15–28, pp. 113–118.
Pearse, W.: 1976, ‘Charges of Widespread Unnecessary Hysterectomy Use Denied,’ Reported in Obstetrics and Gynecology News, July 1.
Polanyi, M.: 1962, Personal Knowledge: Towards a Post-Critical Philosophy, Harper and Row, New York.
Polivy, J.: 1974, ‘Psychological Reactions to Hysterectomy: A Critical Review,’ American Journal of Obstetrics and Gynecology 118, 3, pp. 417–426.
President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research: 1982, Making Health Care Decisions: the Ethical and Legal Implications of Informed Consent in the Patient-Practitioner Relationship Volume One: Report. U.S. Government Printing Office, Washington, D.C.
Richards, N.: 1951, ‘The Surgical Menopause Following Hysterectomy,’ Proceedings of the Royal Society of Medicine 44, pp. 496–498.
Roeske, N.: 1978a, ‘Quality of Life and Factors Affecting the Response to Hysterectomy,’ The Journal of Family Practice 3, pp. 483–488.
Roeske, N.: 1978b, ‘Hysterectomy and Other Gynecological Surgeries: A Psychological View,’ in M. Notman and C. Nadelson (eds.), The Woman Patient: Medical and Psychological Volume I: Sexual and Reproductive Aspects of Women's Health Care. Plenum, New York, pp. 217–231.
Studd, J. and Thom, M.: 1981, ‘Ovarian Failure and Aging,’ Clinical Endocrinology and Metabolism 10, p. 1.
Turpin, T. and Health, D.: 1979, ‘The Link Between Hysterectomy and Depression,’ Canadian Journal of Psychiatry 24, pp. 247–254.
Utian, W.: 1975, ‘Effect of Hysterectomy, Oophorectomy and Estrogen Therapy on Libido,’ International Journal of Gynecology and Obstetrics 13, p. 97.
Walker, B.: 1983, The Woman's Encyclopedia of Myths and Secrets, Harper and Row, New York.
Webb, C. and Wilson-Barnett, J.: 1983, ‘Self-Concept, Social Support, and Hysterectomy,’ International Journal of Nursing Studies 20, 2, pp. 97–107.
Wright, R.: 1969, ‘Hysterectomy: Past, Present and Future,’ Obstetrics and Gynecology 3, pp. 560–563.
Youngs, D. and Wise, T.: 1976, ‘Changing Perspectives on Elective Hysterectomy’, Primary Care 3, 3 pp. 765–780.
Zussman, L. et al.: 1981, ‘Sexual Response After Hysterectomy-Oophorectomy: Recent Studies and Reconsideration of Psychogenesis’, American Journal of Obstetrics and Gynecology 140, 7, pp. 725–729.
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Bernal, E.W. Hysterectomy and autonomy. Theor Med Bioeth 9, 73–88 (1988). https://doi.org/10.1007/BF00489190
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DOI: https://doi.org/10.1007/BF00489190