The ethical dilemmas of aesthetic medicine: what every provider should consider.
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.Plastic surgical nursing: official journal of the American Society of Plastic and Reconstructive Surgical Nurses 30(3):152-5; quiz 156. DOI: 10.1097/PSN.0b013e3181ee1789
The purpose of aesthetic medicine is embellishment and enhancement. As these procedures are elective in nature, media messages and misleading advertisements do influence those consumers seeking to improve or enhance their appearance. The role of provider demands that prudent guide these treatment options and not only succumb to patient demands. This article discusses the ethical principles of autonomy, beneficence, nonmaleficence, and justice, and presents a framework to guide practice to enhance resolution of ethical dilemmas confronting the provider of aesthetic medicine.
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ABSTRACT: There has been a move in medicine towards patient-centred care, leading to more demands from patients for particular therapies and treatments, and for wish-fulfilling medicine: the use of medical services according to the patient's wishes to enhance their subjective functioning, appearance or health. In contrast to conventional medicine, this use of medical services is not needed from a medical point of view. Boundaries in wish-fulfilling medicine are partly set by a physician's decision to fulfil or decline a patient's wish in practice. In order to develop a better understanding of how wish-fulfilling medicine occurs in practice in The Netherlands, a qualitative study (15 semistructured interviews and 1 focus group) was undertaken. The aim was to investigate the range and kind of arguments used by general practitioners and plastic surgeons in wish-fulfilling medicine. These groups represent the public funded realm of medicine as well as privately paid for services. Moreover, GPs and plastic surgeons can both be approached directly by patients in The Netherlands. The physicians studied raised many arguments that were expected: they used patient autonomy, risks and benefits, normality and justice to limit wish-fulfilling medicine. In addition, arguments new to this debate were uncovered, which were frequently used to justify compliance with a patient's request. Such arguments seem familiar from conventional medicine, including empathy, the patient-doctor relationship and reassurance. Moreover, certain arguments that play a significant role in the literature on wish-fulfilling medicine and enhancement were not mentioned, such as concepts of disease and the enhancement-treatment dichotomy and 'suspect norms'.Journal of medical ethics 02/2012; 38(6):327-31. DOI:10.1136/medethics-2011-100103 · 1.51 Impact Factor
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