I don't see a proper comparison here. Coitus, whether willing or not, cannot compare to evisceration, willing or not. Without anesthesia, going through the act of evisceration, whether well intended or not, cannot be a sanely enjoyable experience (perhaps a masochistic mind could find ecstasy from such an undertaking, but we are not talking aberrations here). It is only through the application of anesthesia of sufficient potency that any invasive surgical application can be tolerated by the recipient, and no amount of consent on the part of the recipient or the provider can mitigate the physical trauma experienced by a normal person.

Further extension of the point would, by way of experience, indicate that a heightened level of pre-surgical anxiety is a common among many patients. Could this anxiety approach levels of those about to experience torture? It would seem a common practice to administer pre-surgical tranquilizers to make the practice routine. There is no doubt that the psyche is well aware of what is pending, and survival instincts will activate.

So if intent is not the inducement to the anxiety and fear so many patients experience prior to surgery, as no reasonable doctor intends to inflict suffering on their client, then what must we conclude about the cause of this aversion, even when we know it is for our own good? It is because we are aware of the risks, and we are aware of the pending trauma our bodies are about to go through, even though we will be rendered virtually unconscious and will have no memory of the event in any case. So many times, I have seen patients in prep tremble uncontrollably, right up until the nurse sticks the hypo into the IV and administers the "joy juice" as some of them call it. The purpose: to calm them down and help them deal with the anxiety. Imagine what effect such a thing would have on someone facing torture.

So intent is not a factor. Normal people don't consent to trauma without motivation, that being to endure for the chance at improved health. Who would rationally submit to any surgical procedure that was not deemed necessary? We do not need our appendix for anything, so why not line up to get them removed? We all face the risk of eventually developing appendicitis, and at a time and place that may preclude other remedies besides emergency surgery, so why not make it preventive care?

Ah, but isn't cosmetic surgery elective for the vast majority? Well, that is mitigated by other motivations, with perceived benefits. As before, normal people do not consent to trauma without motivation, and some feel that cosmetic surgery can lead to an improved quality of life. Ok, but they still require anesthesia for the operation, and many still need the pre-op tranq to deal with the anxiety.

So it would seem the similarities of torture to modern medicine, as we have all now had a hand in defining the parametric comparisons and exclusions, remains conclusive. Without the anesthesia, the experiences would be similarly miserable, and neither intent nor desire would have any differing effect on the endurability of either.

This thread reminds me of the scene from the movie Monty Python's the Meaning of Life, where the non-doctors have come to collect the liver from a man who filled out a donor card. Well intended fellows I suppose.