What is unnecessary surgery? Who shall decide? Issues of consumer sovereignty, conflict and self-regulation

This paper presents the results of a study of selected surgical procedures in Queensland, Australia. The data are compared to trends in the U.S.A. and England and Wales. Attention is drawn to the limitations of such epidemiological data as the basis for inferences about the necessity (or otherwise) of particular operations. This leads to a discussion of unnecessary surgery in the light of arguments for and against consumer sovereignty and the self-regulation of the medical profession. Faced with differences of opinion, and the problems of reconciling expert and consumer views about necessity, we argue that claims and counter-claims about unnecessary surgery should be opened to closer scrutiny. A review committee format based on medical and non-medical participation is proposed to achieve this end.