I’m not talking about reconstruction after an accident or illness, or about correcting a deformity.
Doing a little research about the Hippocratic oath before posting, I was surprised to learn that it doesn’t always contain the “do no harm” phrase that I’d assumed it did. Also surprising was that not every doctor takes an oath, and that oaths vary widely from med school to med school.
Let’s discuss the ethics of exposing a “patient” to the risks of surgery to inflate their breasts, straighten or shrink their nose, suck out fat, etc. purely for cosmetic reasons, not for health benefits.
But…“cosmetic” benefits ARE “health” benefits, mental health, that is. Someone who hates her nose or her breasts bad enough that she’s willing to undergo the risk and expense of surgery is someone who’s entitled to have modern medical science assist her, the same way that modern medical science would assist her if she’d been in a car accident and needed fixing.
Besides, where does it say that the doctor is supposed to be Your Mother, making decisions as to whether you ought to have a certain elective surgery or not?
Doctors don’t even make the decision for you as to whether you have non-cosmetic surgery–if you really don’t want that mastectomy for breast cancer, the doctor can’t force you to have it.
The place where I could see it getting unethical is docs who repeatedly operate on people who are addicted to surgery or have body dismorphic disorders and whose mental health doesn’t really improve with each surgery.
Where do you draw the line? Sure, aging Chichi LaVoom (44-29-35, even at 55) wants to continue to look glamorous, and her plastic surgery is what you’re targeting. At the other extreme, the 19-year-old whose face was badly burned in the fire that killed most of the rest of her family – well, her plastic surgery is technically elective: there’s not a medical necessity for it, and she could theoretically go through life with the left side of her face mostly burn scars. But in between there are a lot of grey areas. I’ve lived quite nicely all my life with a deviated septum and spur in my nose, albeit with a lot more congestion than most people get – that surgery would be elective and cosmetic, though for health reasons. I’m not coming up with clear examples of the in-between sort of tough-to-draw-the-line cases, but one of the reasons we find good looks aesthetically pleasing is that they identify healthy individuals (at least in theory: let’s not discuss anorexic models, etc.) Someone whose bad posture or odd-looking jaw makes them unattractive is also likely to have “real” (physiological as opposed to mental/emotional) problems resulting from it. It gets really difficult to identify a clear line between appearance and medically suggested as you begin examining the in-between cases.
Provided all parties concerned are consenting adults and nobody is forced or deceived into submitting to surgery, it’s just between doctor and patient.
Of course plastic surgery can be abused and there are people who are undergoing it for questionable reasons, but “my body is my body.” If I want to alter it for my own reasons I want to work with a responsible, capable doctor who knew the procedures and the risks and it’s no one elses business.
That also means, of course, that if something goes wrong, I have nobody to blame but myself and the doctor.
That was just for example. I’m fine with myself, horns, tail and all.
I’m not sure that getting cosmetic surgery would improve one’s mental health, even if they’re overwhelmed with grief about their small breasts or saggy butt.
I had a friend who hated his nose. It had an extra bump in it or something (I never really noticed). He was obsessed with his bumpy weird nose so much that he was overjoyed when he was ready to undergo plastic surgery to remove this unsightly bump.
He was happy for awhile, but after a few months he fell into a deep depression and was kind of manic at times as well. He was unpredictable and just…weird. Then he spent some time in the psychiatric ward. I haven’t seen much of him in years.
It was almost as if his nose-bump incarcerated all his insanity, and once the bump was removed, all the mental problems flew out, all Pandora’s box-like.
Something I found kind of weird about doing transcription for plastic surgeons is the way they talk about the patient’s problems. For example “She has a marked saddlebag deformity.”
Ooh, sounds serious. It’s a “deformity.” You need surgery for that. It feels like a rationalization.
I have no problem with those who get cosmetic surgery, though I think the majority of people look better before than after–at least when it comes to facelifts, breast implants, nose jobs, botox, other injections, etc. Plastic surgery after major weightloss is another issue.
Performing “cosmetic” plastic surgery is unethical if you don’t fully explain the risks and benefits to the patient. It may also be legally actionable.
It is also unethical if I have to pay for your facelift.
As to the Hippocratic Oath, there are some good parts to it, but many would prefer not to swear an oath to abstain from providing abortion services or helping in assisted suicide in certain cases, not to mention swearing to Apollo in the first place (the part I have trouble with is the requirement that I kick back some of my income to my med school professors).
We didn’t take the Oath at my med school, but I try to stay out of mischief anyway.
Hm, I personally think that I could have done without bleeding off and on for the last 20+ freaking years. I had my tubes tied. I dont see why I couldn’t have had a hysterectomy so I wouldn’t have monthly labor pain and the lovely experience of essentially bleeding out along with it.
As long as I have ovaries for the hormones, who cares if I have a stupid little flesh pouch with aboslutely NO use other than tormenting me monthly with agony and blood.
As long as the patient is fully informed of and understands (and is legally authorized to accept) the risk, and as long as persons not the patient don’t have to pay for it, then there’s nothing unethical about elective surgery.
It’s unethical to butt into the personal lives and choices of any two consenting adults, even if one is a doctor and one is a patient.
The doctor has an ethical duty to present the risks, to be properly qualified so as to minimize them, and to make an appropriate judgment that the patient is able to process that information.
I’ve never quite understood why plastic surgery tends to raise any hackles on the part of those not involved in the contractural relationship. (Jealousy that not everyone has to play the cards mother nature dealt them? )There seems to be an implied theory in the OP that it might be construed as unethical to expose another individual to an unnecessary risk when the precipitating reason is their personal pleasure (and perhaps when one party is being compensated).
Under that notion it’s unethical for a bungee jump operator to be in business.
I’d agree with this statement: In particular, what part of ethics are we talking about. Unethical, as in the oath the doctor (might have) taken is broken because he’s not doing some sort of necessary medical procedure? I would think that the medical community should be the judge of that and they seem to be okay with it…
Barring that, unethical because…what exactly? I can’t really (besides the above) fathom what grounds of ethics you’re coming from. Like CP implied, you might think it’s personally unethical to pursue the surgery in the first place, but that’s not for the community at large to decide (since it doesn’t affect us) but the doctor and patient to decide.
