Title: Ethical and Policy Questions re Ideals of Beauty, Cosmetic Surgery, and Obesity
1Ethical and Policy Questions re Ideals of Beauty,
Cosmetic Surgery, and Obesity
2Ethical and Policy Questions
- What roles do culture, the media, sexism, and
racism play in individual and public perceptions
of beauty? Individual and collective perceptions
of ideal body weight? The response of society to
outliers and development of pathological
behaviors? The desire for cosmetic surgery?
3Ethical and Policy Questions
- Is aging defined as a physical and/or mental
illness? If so, is the substitution of happiness
for health an appropriate goal for cosmetic
enhancement? Does this enhancement constitute
medical treatment? Or is cosmetic surgery simply
a business service provided to those who desire
it, can pay for it, and are willing to accept the
risks involved?
4Ethical and Policy Questions
- How do providers and insurers define medical
necessity as it relates to cosmetic surgery?
5Ethical and Policy Questions
- A sizable minority of physicians admits to
"gaming the system" by manipulating reimbursement
rules so their patients can receive treatments or
undergo procedures the physician deems necessary.
How often do cosmetic surgeons "shade the truth"
in attempting to obtain coverage for services
they perceive to be necessary for their patients?
6Ethical and Policy Questions
- How much revenue-generating cosmetic surgery is
too much for underfunded, university dermatology
(or plastic surgery) departments? What are
appropriate arrangements for using such revenue
to cross-subsidize indigent care?
7Ethical and Policy Questions
- To augment lagging revenues and offset budget
deficits, states have begun taxing cosmetic
procedures New Jersey's levy is 6. Should
cosmetic surgery be subjected to the same sort of
consumption taxes as cigarettes and gasoline?
8Ethical and Policy Questions
- Many endocrinologists treat short-statured,
non-growth hormone-deficient children with growth
hormone. Is it appropriate for parents to consent
to such "treatment" and for physicians to offer
it?
9Human Growth Hormone
- Provision of growth hormone may augment height
and enhance social acceptability (and ability to
make the basketball team), but can carry
potential long-term side effects such as diabetes
and hypertension - Treatment requires six injections per week for
4-5 years at a cost of 20,000/yr
10Ethical and Policy Questions
- Should surgeons correct the physiognomy of
children with Trisomy 21, giving them a "normal"
appearance while leaving their underlying
neurologic defects and distorted voices
unchanged? How will such surgery affect their
emotional development and integration into
society?
11Ethical and Policy Questions
- What cosmetic procedures are acceptable in
consenting adolescents?
12Ethical and Policy Questions
- Should cosmetic surgery be used to transform
racial characteristics, by (as one author put it)
"transforming a Black nose into an aquiline nose
better befitting a British butler," or by
rounding off the eyelids of Asians? - Most surgeons would say no. However, some
surgeons still refer to reconstruction of the
Jewish nose, a moniker implying a physical
deformity. - Asian eye surgery common in Taiwan, Japan, and
Korea - Sometimes performed on children
13Ethical and Policy Questions
- How should professional societies regulate the
evolving field of genetic aesthetic enhancement?
What, if any, differences exist between eugenics
and genetic aesthetic enhancement?
14Ethical and Policy Questions
- What are the appropriate actions of health
professionals, lawyers, teachers, ethicists and
governments in responding to ideals of beauty and
body weight, and to unhealthy behaviors and
unsafe and/or unethical cosmetic surgical
practices?
15Covered in Other Slide Shows
- Ideals of beauty and body modification
- Female genital cutting
- Body weight and the obesity epidemic
- Ethical and policy issues
16References
- Donohoe MT. Beauty and body modification.
Medscape Ob/Gyn and Womens Health 200611(1)
posted 4/19/06. Available at - http//www.medscape.com/viewarticle/529442
- Donohoe MT. Cosmetic surgery past, present, and
future scope, ethics and policy. Medscape Ob/Gyn
and Womens Health 200611(2) posted 8/28/06.
Available at http//www.medscape.com/viewarticle/5
42448
17References
- Donohoe MT. Female genital cutting epidemiology,
consequences, and female empowerment as a means
of cultural change. Medscape Ob/Gyn and Womens
Health 200611(2) posted 11/06/06. Available at
http//www.medscape.com/viewarticle/546497 - Donohoe MT. Weighty matters public health
aspects of the obesity epidemic. Parts I-V.
Medscape Ob/Gyn and Womens Health 2007 and 2008
(see http//phsj.org/?page_id10)
18Contact Information
- Public Health and Social Justice Website
- http//www.phsj.org
- martindonohoe_at_phsj.org