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Issue 193: : Prophylaktische Mastektomie bei familiär bedingtem Mammakarzinom - medizinische, ethische und sozialrechtliche Überlegungen. May 2012

In consideration of the state of scientific medical knowledge, the thesis „Prophylactic mastectomy for the treatment of familiar breast cancer – considerations of medical, ethical and social law issues” analyses ethical principles to justify surgical applications for prophylactic operations, especially bilateral prophylactic mastectomies (BPM) in healthy women with risk of familiar/hereditary breast cancer. With respect to a rational concept of the applied ethics to substantiate acting under risk, the criteria of risk and harm assessments in systematic decision analyses were analysed for normative ethical justification of medical practice. The challenges of the presented clinical problems open up new ethical questions in the context of a “predictive medicine”. They seek for further approaches of ethical well-founded justifications for decisions. Based on the regulations of the social law, options of the German statutory health insurances for the reimbursement of prophylactic mastectomies were discussed.