Ethical and Policy Questions re Ideals of Beauty, Cosmetic Surgery, and Obesity - PowerPoint PPT Presentation

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Ethical and Policy Questions re Ideals of Beauty, Cosmetic Surgery, and Obesity

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Title: Ethical and Policy Questions re Ideals of Beauty, Cosmetic Surgery, and Obesity


1
Ethical and Policy Questions re Ideals of Beauty,
Cosmetic Surgery, and Obesity
  • Martin T Donohoe

2
Ethical 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?

3
Ethical 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?

4
Ethical and Policy Questions
  • How do providers and insurers define medical
    necessity as it relates to cosmetic surgery?

5
Ethical 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?

6
Ethical 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?

7
Ethical 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?

8
Ethical 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?

9
Human 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

10
Ethical 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?

11
Ethical and Policy Questions
  • What cosmetic procedures are acceptable in
    consenting adolescents?

12
Ethical 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

13
Ethical 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?

14
Ethical 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?

15
Covered in Other Slide Shows
  • Ideals of beauty and body modification
  • Female genital cutting
  • Body weight and the obesity epidemic
  • Ethical and policy issues

16
References
  • 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

17
References
  • 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)

18
Contact Information
  • Public Health and Social Justice Website
  • http//www.phsj.org
  • martindonohoe_at_phsj.org
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