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Doctors have a duty to do no harm and you aren't offering a service like any other business but are obligated to either help patient's have improved outcomes, or at least not to harm them.
The attitude "fuck, why not" goes completely against how the medical profession ought to operate and if followed by doctors in practice, it should come with professional penalties. Indeed, this even applies to more mild things. Cardiologists don't tell their obese patients, at least if they are good, "eat what you want, what the fuck do I care", they tell them to change their diet, and to walk around. And much more. And should not be Cardiologists if they don't do this.
Doctors shouldn't help self destructive patients to destroy themselves either totally, or in part. I certainly wouldn't want even a cent to go to pay for doctors doing that. Nor should they be allowed.
Now, medical tyranny of safetyism is another danger of doctors acting unwisely which also goes against proper medical ethics. Indeed in certain studies apparently prisoners of certain demographics, IIRC black Americans, live longer than those of same demographic outside of prison, but maximizing life at expense of imprisoning people would obviously be an undesirable outcome.
Then there is the worst behavior for doctors to hypothetically engage in which is a combination of both. Being too tyrannical where one ought not to, and not guiding patients or restricting them from self harm but indulging in it, where one ought not to. With some of the covid measures and lockdowns and the trans issue and the OP issue we can see that they can coexist among the medical establishment.
Anyhow, ideally we would see from doctors some level of paternalism but not too much, and focused in the areas it is wise too focus upon, but also seeing "do no harm" as an important principle. Which means not allowing operations described in the OP and then we would need to see the proper way to deal with doctors who abused their position and mutilated their patients. Whether only very severe professional penalties are appropriate, or whether there should be prison time as well.
I think this is what happens when status and money is highly placed on a profession. After a certain amount of time there will be people that just want the associated benefits and resources that lack the mentalscape desired for the profession. Add to that societies of very low trust like India or Latin America and its a recipe for disaster unless you thoroughly vet your doc.
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