A.
Introduction
Nowadays,
science development and technological progress have provided us with new
comforts and many other advantages. In the area of science, biomedical science
has given us new possibilities to alter and modify various life forms. One of
them is cosmetic surgery which can improve one’s appearance and even change
totally his/her human form. For instances, a child who was born with medical
problems and those who have body damages can be improved by cosmetic surgery.
However, there are people who just want to make their noses shapelier, larger breasts,
thinner legs, flatter ears, etc.
We are living in a world that beauty
and self image have become an obsession and this kind of procedure panders to
that. Cosmetic surgery is the latest phenomenon in the long history of the
objectification of women in society. In general, the pressures of appearance
apply particularly to women. We can see in the media that many actresses and
models undergo major breast enlargement surgery, facelifts, rhinoplasty,
etc
with the intention of aesthetic and
beauty. These days, the role of the media
gives too much emphasis on aesthetics which make many people worry about their
appearance. The media consistently implies that unless we are beautiful or
handsome, we will never succeed in life or even find a mate.
The
significance of this study is not just simply to inform the readers to
acknowledge the reality of cosmetic surgery in our society today, but also to
help them to see the impacts of this phenomenon and the intention behind it
which can be judged morally. An online website, American Society of Plastic
Surgeons (ASPS)
conducted a study in 2007 in the USA which it shows that many American people are
quite worry about their appearance and believe that if they have a good
appearance they will easily get a better job. The ASPS notes that almost 12
million cosmetic surgery procedures were performed in 2007 which has been
increasing 59 % since 2000. The ASPS found that the top five surgical
procedures were breast augmentation (348,000, up 6%), liposuction (302,000),
nose reshaping (285,000, down 7 %), eyelid surgery (241,000, up 3%), and tummy
tuck (148,000, up 1%).
This
issue becomes debatable because many people are trying to criticize, or even
against it and many other people accept it as something normal in our society.
Some people argue against cosmetic surgery because it seems more like
vanity/self indulgence and wasteful in term of spending money for other needs.
The detractors believe that it’s much nobler to expend our efforts and spend
our money improving our mind and knowledge rather than our bodies. Proponents
on the other hand, point out that we spend time improving ourselves in many
ways. This issue is morally
problematic even though anything someone pursues to make him/herself look or
feel better is not morally wrong. In fact, beautifying and enhancing ourselves
is a neutral human instinct, but when we come to a moral judgment, every action
of cosmetic surgery is being judged according to the reasons and motivations we
are taking. It can be beneficial for one self but also it can be an act of
vanity or self-indulgence.
B. Notion of
Cosmetic Surgery
According
to Ducan, one of the editors of Dictionary
of Medical Ethics, cosmetic surgery is more related to the art of adorning
or beautifying the body or improving appearances.
In medicine and healthcare world view cosmetic surgery is a specialized area of
medicine that deals with the enhancement of the human form. It concerns with
the repair, restoration, or improvement of lost, injured, defective, or
misshapen body parts. In other term some people call it as plastic surgery
which use of the word “plastic” is considered to be synonymous with “fake” or
“superficial.”
The
ASPS describes that there was already medical treatment for facial injuries more than 4,000
years ago (about 800 B.C.E) by physicians in India who were utilizing skin
grafts for reconstructive work. Then, the wars during the late 19th
and early 20th century drove the development of cosmetic surgery in
order to repair facial defects of the soldiers caused by war.
In few years after progress
in medicine of plastic surgery moved quickly that has been affecting the
aesthetic procedure until now. Consequently, plastic surgeons
began to realize that cosmetic surgery procedures could also be used to enhance
beauty.
Benedict
M. Ashley notices that cosmetic surgery has two major components, reconstructive
and cosmetic. First, reconstructive
surgery involves restoring damaged or altered parts of the body (via genetics,
trauma, disease, etc) that are usually not the result of normal aging. This includes
things like cleft lip and palate repair, removal of excess skin after massive
weight loss, pinning back of prominent ears, skin grafts, facial fractures and
lacerations, scar revisions, coverage of massive tissue, etc. On the other
hand, He defines cosmetic surgery as purely changing aspects of the body to
alter the course of aging or to make a body part that is “normal” look better. The
purpose of cosmetic surgery is simply the enhancement of sexual attractiveness
or the concealment of normal aging, such as facelifts,
rhinoplasty, breast enhancement, liposuction, eyes and eyelids, chin surgery or
mentoplasty, ear surgery or otoplasty, dental surgery, tummy tuck, etc.
C. ETHICAL
AND MORAL ISSUE IN COSMETIC SURGERY
·
The Concept of Beauty and Normal in Cosmetic Surgery
There
are some reasons why people undergo cosmetic surgery. First of all, one of the most important reasons is feeling
uncomfortable or even discontent with body. Many people see their self-esteem
is just linked with how they look. We cannot deny that our society has built
this kind of feeling such as young, fresh, smooth, white, and shiny skin of
body especially woman’s body which has been shown in mass media through
advertisement. As a matter of fact that the main reason of cosmetic surgery is
to make people feel better about themselves. Most people are motivated to
undergo cosmetic surgery because of body-image dissatisfaction. Linda L. Alexander and companions find that many women
look for cosmetic surgery because the media has created the body image which results
in their excessive dieting and eating disorders. By quoting International Study
of body language in 1997, Linda shows the increasing of women who are discontent
with their bodies, appearance, and weight.
The
second reason is considering the fact that western culture
has proven to be the dominating world culture, so there is a kind of racial
inferiority in our society today. Therefore, many people tend to be more
western looking. Cressida J. Heyes, a feminist who studies on cosmetic surgery
in Asian context figures out that all cosmetic surgeries are ethnics.
In the same line, Ducan also points out that alteration of normal ethnic
features by removing and improving certain parts of body to make one’s self
more western looking. According to the study of an online website, Psychology Today,
cosmetic surgeons use medical terminology and racist descriptions to convince
potential patients that eyelids without folds are "sleepy" and that
flat nasal bridge signify a "lack of force" in character. For this reason many Asian people visit their
cosmetic surgeons to have their eyelids ceased, their nose bridges heightened,
their nose tips sharpened, etc.
Third reason is a kind of youth illusion
that develops nowadays. Many people are
trying to undertake cosmetic to be look younger because of the “old” image is a
grumpy and ugly.
Psychology Today notes that this is a
natural response, but this kind of fear can be easily happened to those who are
in the golden years of life. People tend to lose their
appreciation for aging naturally and finding beauty in other people of all
different ages. This can be symptomatic of a society where old people are no
longer reverent and respected. In this society old people have negative
association of wisdom and experience. It gives us the impressions that we are
living in a society where natural beauty is dead.
The
fourth reason is rooted in the desire to feel sexier or
sexually attractive. There is a kind of feeling of sexual incompleteness that
force people to attract others and look for sexual recognition. For example, a
woman has a flat chest will undergo breast implants in order to look sexier to
others. Sandra Leiblum and Judith Sachs prove that
more and more believe that changing the outside will resolve the conflict and
discontent going on within. It is marked by the increasing of people who
undergo cosmetic surgery in order to feel beautiful and sexy.
Judith Sachs herself acknowledges the effect of cosmetic surgery after her
cosmetic surgeon removed all the scar tissue in her body. She feels sexier
because her body is so well adjusted and she feels more comfortable with her body.
In
my opinion, the big problem with cosmetic surgery is what people are defining as “beauty
and normal”. Mass media has the most significant roles in creating body image
about anything less than perfect is not “ beauty and normal.” Psychology Today shows that some
patients in consultation and in the operating room are some of the most
psychologically complex patients in all of medicine (and quite often unstable).
Some have become so convinced and brainwashed that a certain aspect of their
body is not “normal” that their identity and self-worth are all balanced on the
potential of a scalpel.
·
Is Cosmetic Surgery an Idolatry of the Body?
Cosmetic
Surgery can be taken into account as one kind of idolatry of the body because
it is merely patching up the outside and not the wholeness of a person. It in
many ways promotes worship of physical human beauty by correcting or changing a
part of the body in order to improve physical appearance. Though there are some
surgeries that are undertaken in order to correct malformations resulting from
injuries or deformity. These latter surgeries have to be acknowledged as a
positive thing in our society. Therefore, all these procedures of surgeries
reveal a person’s image of the human body to a worldly standard. The question
is how we come to judge cosmetic surgery as morally justifiable or not?
According
to the Catechism of the Catholic Church number 2289, “the church rejects a neo-pagan notion that tends to promote the
cult of the body, to sacrifice everything for its sake, to idolize physical
perfection and success at sports.” It gives us the idea that this statement is implicitly
related to the practice of cosmetic surgery because by some means it relates to
the human body, but generally the Church never condemned it specifically and
officially. The issue here is overemphasize or exaggerate in caring of the body
by some means is not in the line with the Church teaching about human body and
human person because they see the bodily earthly life as the definitive one. It
is different case from the obligation of the body which is intrinsically good.
In short, balance has to be here regarding to the
task to take care of our own body. Those who are too much focus on their body
and how it looks are led by the preoccupation with fashion and keeping up with
advertising attention by going far beyond what modesty word require. It gives us
the impression that cosmetic surgery is necessary, but it is unessential for a
person who undergoes it without any significant reason.
·
The Role of Physician in Cosmetic Surgery
Cosmetic
surgery is not merely a personal decision, but also needs the physician’s
approval. Every action relates to morality and ethics in our society. One
ethical issue in cosmetic surgery is about autonomy. In terms of making
decisions, patients are free to choose cosmetic surgery and spending money for it
because of his or her autonomy as a human person. The other ethical issue
relates to the physician or surgeon. Physicians should provide a maximum
benefit for the patients such as the health of the patients and their safety.
We
have to consider that all kinds the surgery involves risks that must be fairly
well defined before surgery undertaken. Ethical consent denotes a
decision-making process based on mutual respect and full disclosure between
doctor and patient. Surgeon needs to accurately ascertain the emotional state
and the patient’s expectation (with the help of psychologist or psychotherapist).
In addition, surgeon needs to know what is aesthetically pleasing to surgeon
may differ from what patient imagines as ideal result.
Regarding
to this ethical issue, Benedict M. Ashley, says that we have “ethical norms
that we should respect the rights of others.” He adds that we need to
understand what a right is, and then allow people to make their own decision
about health care procedure.
There are several norms regarding to the content of Catholic Health care ethics
derived from the experience of human beings enlightened by the teaching and
examples of Jesus for centuries such as the principle of well formed
conscience, informed consent, double effect, cooperation, professional
communication, human dignity, common good and subsidiarity, totality and
integrity, stewardship and creativity, inner freedom, personalized sexuality
and growth through suffering.
We know that many people undergo cosmetic surgery for merely aesthetically
improved personal appearance. Nevertheless, the questions that here are about
their necessity and moral legitimacy because the fact that cosmetic surgery always
involves some risks. The Church gives answers using the application of the
theological principle of totality, autonomy and in the examination of the
intentions and consciousness. Applying the principle of totality the Church
consider that it could be morally acceptable and reasonable because even though
there are risks involved we have to admit that there are a lot of personal
advantages anticipated in a particular cosmetic surgical procedure. To apply
autonomy and consciousness in cosmetic surgery, the Church recommends that it
should be undertaken by a person who is really free from any pressure
(autonomy) and he/she is aware of the risks. In terms of the intentions, cosmetic
surgery could become morally wrong if undertaken for a wrong intention such as
to feed one's personal vanity inordinately, to facilitate some immoral
activity, or for a criminal to evade justice or make easier the commission of
further crimes.
James F. Drane, in his theory and
practice in making medical-ethical decision explains that:
“The
principle of patient autonomy or patient’s right to give an informed consent is
first of all a right to refuse treatment and the right to choose from medically
justifiable options. … Physicians should maintain communication with patients
throughout the patient participation in medical decision-making.”
He
emphasizes that this principle applies in order to help and not to harm the
patients. In this sense, it becomes clear to us to consider that a physician must
treat the patient as a person and not as organ or tissue. In other words, there
is the patient autonomy and the physician beneficence.
·
The Benefits and the Risks of Cosmetic Surgery
We are aware of the facts that the benefits of
cosmetic surgery are fantastic both physically and spiritually or emotionally.
For example, people will not only look and feel younger, prettier, fresher,
thinner, skinny, etc, but also become more confident, more outgoing, more
personable because the rise of self-esteem. Consequently, people become more
active in their work and much healthier because they find themselves psychologically
and physically are balance. They become more focus on their job and
responsibilities rather than conscious and worry about their physical problems.
These are some significant advantages in improving one’s appearance.
We should acknowledge and appreciate that modern
procedures have greatly dismissed most risk in cosmetic surgery and it has
given a lot of benefit for improving one’s appearance. However, like many
other procedures, cosmetic surgery has some degree of risks. Therefore, the
patients should consider the possible dangers
and risks involved in any kinds of cosmetic surgery. Beautifying and
enhancing ourselves is neutral human intrinsic, but its risks and effects have
to be weighed maturely. The ASPS confirms that it
is a business service provided to those who desire it, can pay for it and are
willing to accept the risks involved. Lack of legal safeguards and medical
accountability, and the probability that only badly qualified doctors will
offer illegal operations will defer almost everyone from risking black market
surgery. Benefit of it is still not covering up the fact that its intention is
to make money, not to make people better.
Regarding to the dangers of cosmetic surgery Magdalena Alagna,
by referring to Encyclopedia of Medicine describes some common risks of
cosmetic surgery such as:
Scars, bleeding, infection and hematomas, and nerve damage. Scars is one of the
most common risks Sometimes people may have to get more cosmetic surgery to get rid of
ugly scars. She proves that most surgeons will try to hide incision lines in
places where they aren't noticeable, like under the crease of the breast in
breast augmentation plastic surgery and in the hairline in facial plastic
surgery, but most surgeries will still result in permanent scarring. Bleeding,
infection and hematomas are possible after surgery, but if these complications
are caught early on they can usually be treated. Nerve damage is a serious
complication. Some people who undergo plastic surgery will lose feeling in the
area that was operated on while others may experience problems moving muscles
in the area where the surgery was performed. Therefore, the patients should
consider and be aware of all of these risks before undertaking cosmetic
surgery.
In the same line, Alagna also
shows some risks associated with some of the most common procedures such as breast
augmentation which risks include sensory damage around the operation site,
discoloration of the skin, tissue necrosis, asymmetry, infection, formation of
scar tissue, and allergic reactions to sedation. Facial plastic surgery, on the
other hand, can lead to noticeable tissue damage, unnatural looking features
and premature aging. Not only will the procedure determine the risks involved
but so will the individual. Smokers, people with diabetes, heart conditions and
certain allergies are more likely to experience complications that other people
can avoid. It is obvious that the type of procedure will
determine the risks that are involved.
For that
reason, Alagna suggests that it is important for the patient to have blood
tests and a physical done to ensure that he or she is a good candidate for
surgery and to look into the procedure the patient is considering and learn
about the risks involved.
The risks of plastic surgery will differ depending on the individual and the
procedure they opt for. Plastic surgery complications can range from scarring
to fatalities and the effects of surgery can sometimes be traumatizing to
patients both physically and psychologically.
·
Cosmetic Surgery, Career and Human Dignity
We are
living in a society which has changed dramatically. Now, we are in the state of
crisis in the economy and global recession which people tend to believe that
appearance and good looks, beauty are really matter in the business world. This
strongly influences the hiring and firing policy at workplace. For instance people
are forced to undergo cosmetic surgery with the intention of enhancing their
appearance because it will give them great advantages to get job easily. The
survey conducted by online website, Psychology Today releases that most of
women in the USA were going for cosmetic surgery just to get a competitive edge
in the workplace and secure their career. The ASPS concludes that cosmetic
surgery plays an important role in achieving professional success.
Furthermore, there are many people who do
cosmetic surgery out of pressure from the romantic partner, family or friends. The
pressures of appearance apply particularly to women. In many
cases women, especially young brides, sometimes do cosmetic surgery under
pressure from family or romantic partner before the wedding in order to look
prettier for the new husband. People who have problems with their appearance
tend to undergo cosmetic surgery because of their rejection sensitivity. Many
researches approve that people who feel rejection based on their physical
appearance are more likely to express interest in having cosmetic surgery than
those who are less sensitive to a consolation; that individuals who anxiously
expect rejection based on their appearance are vulnerable to the effects of
negative comments about their appearance.
The question that arises here is why someone should change his or her look just
to make others happy?
I consider that people are just amazed with
someone who has normal or even best physical standard of appearance. For me,
the most important thing here is a matter of acceptance of others as they are,
not only based on their look, but as person or an individual. Society
has created an image of beauty and normal which is continuously bombarded by
the media. Many people are forced to alter their look in order to conform to
what portrayed on TV or other media. This is the consequence of over
emphasizing on aesthetics by media and make people not be happy with what nature
has given them. Media create the myths and beliefs that those who are beautiful
or handsome and look normal will succeed rather those who are not. In other
words, cosmetic surgery can improve one’s relationship and helps to get job,
but we should consider that cultural
changes increasingly emphasize one’s physical appearance as a qualification in
many sectors of the business world.
According
to James Keenan, the Christian tradition has always insisted that the human body
is not simply an object but it is always a person, a subject. The Christian
tradition is to direct us away from any tendency to isolate or objectify the
body. He shows some kinds of manipulation of body such as pornography,
prostitution, selling of organs, genetic engineering, and cloning. People
manipulate the body without looking upon how it affects the kind of persons they
would become. On the other hand, some people may manipulate themselves in order
to be more acceptable to others by taking cosmetic surgery, idealization of
certain body types through advertising, promoting unhealthy body models to
children. All these are a kind of overemphasis on the body as a determinant of
the person’s worth and dignity. These can become a kind of discrimination
because people manipulate their body to be accepted.
We
do not just have our body, we are our bodies. An integral human development
refers to the development of the whole person and every person. To be a subject,
the human body needs its own voice. Human body provides means to be united intimately
with Christ which in our Christian tradition is extraordinary physical –
incarnation. The Church seeks to care for the needs of both the spiritual and
physical dimensions of the human person. Healthy appreciation of the body
promotes the common good that would benefit the live of every person. Therefore
we must avoid a negative view of the body as evil or less important than the
soul. For instance, promoting cosmetic surgery or undergoing cosmetic surgery
purely because of shame of body or identification of a part of the body as bad.
We cannot make judgments on the moral and spiritual state of a person based on
their physical state such as manipulating the body through cosmetic surgery in
order to make one self more acceptable.
Cosmetic surgery by some means relates
to human dignity. Catholic Church clearly underlines that:
“The dignity of the human person is
rooted in his creation in the image and likeness of God (article 1); it
is fulfilled in his vocation to divine beatitude (article 2). It is
essential to a human being freely to direct himself to this fulfillment (article
3). By his deliberate actions (article 4), the human person does, or
does not, conform to the good promised by God and attested by moral conscience
(article 5). Human beings make their own contribution to their interior
growth; they make their whole sentient and spiritual lives into means of this
growth (article 6). With the help of grace they grow in virtue (article
7), avoid sin, and if they sin they entrust themselves as did the prodigal
son1 to the mercy of our Father in heaven (article 8). In
this way they attain to the perfection of charity” (Catechism of the Catholic Church
No. 1700).
Catholic
Moral theology after Vatican II gives more attention to the human person, in
all his/her dimension and historical development. Human person is adequately
considered when she/he is taken as the image of God – sacredness and dignity of
every person, a relational being - to be human person is to be toward others.
Human person also is an embodiment subject – a moral agent with certain degree
of autonomy and self-determination empowered to act according to her
conscience, freedom and knowledge. As a historical subject each person should
be respected in our developmental process, and considering person as persons on
a journey of growth and can develop and change through time. We need to
consider also that as a human person we are fundamentally equal but uniquely
original. We seek to promote what is universally good for all but we must allow
for diversity in the expression of what is morally good according to the unique
culture and background of individuals.
d. Conclusion
There
are a lot of opinions regarding cosmetic surgery, but as the bottom line here,
I will sum up some significant points which are the following:
First,
Reconstructive surgery is generally considered a good thing in the case of cleft
lip and palate
repair, facial fractures and lacerations, scar revisions, etc. This kind of cosmetic surgery is purely in order to
repair and restore the originally intended order of the body according to what
is "normal" for a human and it is a good thing. Therefore, there is
nothing wrong in these cases. Cosmetic surgery should be undertaken with a prudent
choice of those involved and there is no damage. However, if there is
significant harm done or the surgery is intrinsically wrong, then plastic
surgery should not be done.
Second,
the other matter that should be part of the decision is motivation or intention
is it for a health reason or for pure vanity. Regarding to this, the critical questions
we could be asked is what is the intention? Is the purpose of doing so to hide
a feature we don't like, please someone else, a part of a tribal ritual, etc?
Some reasons are good, some are not.
Third,
cosmetic surgery also relates to financial resources and its procedures because
the procedures might harm the patient (physical, mental, spiritual) and if
there is significant damage to the integrity of the body, then cosmetic surgery
could be morally wrong. For instance, there are some kinds of cosmetic surgery that
can cause parts of the body to lose some or all functionality. Here we can also
ask how this will affect others and can we afford it. We are not only to do as
we wish, but rather we need to think of others and consider our financial
condition. These are three significant aspects that we should consider before
deciding to undertake it.
Some
people have their lives significantly improved by cosmetic surgery, yet there
are also other people who go too far, losing their identities or even their
lives in their pursuit of perfection. Psychologically, people take cosmetic
surgery because they have negative self-image. In other words, they do not
accept their physical reality or are unhappy with their external appearance.
In
my opinion, it’s unfair if the society through the mass media overemphasize the
physical appearance as a quality of one’s life rather the wholeness of a
person. We can see how artificial our live is. The implication here is people
just see human being more likely as an object, not as a subject. We can notice how
the obsession with physical
appearance and the pursuit of conformity to an earthly standard of health and
beauty dominate our cultural landscape, tremendously influenced
by the advertising and entertainment media. The
problem sometimes is as more people are cosmetically
enhanced, so there will be more people suffering from low–esteem, because they
cannot afford to be like the celebrities who look so “perfect”. Therefore, it
is clear that the practice of the cosmetic surgery purely relates to the notion
of physical beauty as defined by certain social norms. ***
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WHAT IS THE DIFFERENCE
