I guess there are many perspectives on this; these are questions that touches on many serious ethical and philosophical topics: health care, the value of life, death, autonomy, ...

There is a tendency in our time to think about all issues in terms of economy. I think that's wrong, that we shouldn't think about life and death as economical questions, that it is a reductive discourse. Others might disagree, of course

For example, is this really a question about being in charge of one's own life or about what services that should be offered in a society? I guess that's also a link to the OB/GYN example you give; at least some health care professionals might think it is unethical to damage an organ or body that's working: primum non nocere

Others, who have another philosophical view on what health care is, may say that the society should offer the services that people want or need