Practice makes perfect: Evaluating the conflict between aesthetic interventions and the ethos of medicine

Yves Saint James C. Aquino, MD, MSc, MRes1

1 Department of Philosophy, Faculty of Arts, Building W6A, Level 7 Room 704, Macquarie University, Balaclava Road, North Ryde, Sydney, Australia 2109;

Aesthetic medical and surgical interventions, which seek to modify physical appearance, remain controversial as they challenge the professional ethos of medical practice. Professional ethos is typically interpreted, at least in clinical medicine, as the use of clinical knowledge, skills, values and judgments to benefit the individual patient. Further, the benefit should be aligned with the accepted medical goals of treatment that promote health and manage disease. Given this interpretation, reconstructive procedures, or aesthetic interventions that aim to restore ‘normal’ features, are considered compatible with the professional responsibility of physicians. However, purely cosmetic procedures, or aesthetic interventions that aim at creating extraordinary or beautiful appearance, can be criticised for aiming at enhancement rather than treatment. In this presentation, I argue that cosmetic enhancement is a questionable application of clinical knowledge, values and judgement of medical professionals. I will discuss how with purely cosmetic aims, some aesthetic interventions tend to conflate ‘ugliness’ with pathology—and beauty with health. This problematic conflation requires further investigation as to whether medical professionals should have responsibility for defining the concepts of beauty and ugliness. I propose that one way of examining this issue is by appealing to different accounts of health and disease. Naturalist accounts define health and disease descriptively, as objective concepts based on biological functions; while normativist accounts consider human values and judgments, not biological functions, as the bases of defining health and disease. Using the naturalist and normativist account may provide a fruitful way of investigating links between appearance and health, and is useful in understanding how aesthetic interventions with purely cosmetic goals can distort the professional ethos of medicine.


Yves Saint James Aquino is a first year PhD student with the Department of Philosophy at Macquarie University. He received a bachelor’s degree in philosophy and a medical degree from the University of the Philippines, an Erasmus Mundus master’s degree in bioethics from partner universities that included KU Leuven in Belgium, University of Nijmegen in the Netherlands and University of Padua in Italy. Before starting his PhD, he received a master of research degree from Macquarie University. His research interest is on the role of physical appearance in defining health in the context of contemporary medicine.

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