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Ethics of Plastic Surgery in Minors: A Case Study and Literature Review
Robert DeVito MSIII
Thomas Kerestes, MD
Ali Kimyaghalam, MD
Julie Aultman, Ph.D.
Northeast Ohio Medical University
2020-01-27
Presenter: Robert George DeVito
Affidavit:
As a medical student, I do not have a program director.
Director Name: not applicable
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics
Case Study: A 16-year-old patient presents to your plastic surgery clinic for consultation about a cosmetic rhinoplasty. She is self-motivated and cites bullying and aesthetic displeasure as her reasoning. Her mother, a former rhinoplasty patient, supports her decision, while her unsupportive father wants her to wait until adulthood. The patient expresses a firm desire for surgery, is aware of the surgical risks and post-operative care and has the means to pay.
Guiding Questions: What are the ethical, legal, and clinical considerations of this case? If you are the consulting surgeon, what additional factors should you consider? What alternatives could be offered to this patient besides surgery?
Analysis: Ethical and legal concepts and theories are utilized toward case resolution, including narrative ethics, principlism, parental consent, and "mature minor" status. Surgical and behavioral health considerations are also examined within the analysis.
Discussion: Plastic surgery requests among adolescents and teenagers is not uncommon. While plastic surgeons are able to physically and psychologically help young patients, who are victims of bullying and mistreatment, ethical guidance is also needed for effective communication, compassionate care and decision-making.
Conclusion: Patients need to be holistically evaluated by a plastic surgeon; ethical, legal and clinical discussions about motivations, emotional maturity, risks, benefits, and alternatives need to take place before plastic surgery should be performed for minors.
