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The e-mémoires of the Académie Nationale de Chirurgie

The Ethical Issues of Plastic, Reconstructive and Aesthetic Surgery

MENINGAUD JP

Seance of wednesday 30 september 2020 (Ethique et Chirurgie)

DOI number : 10.26299/k5yg-5t47/emem.2018.4.010

Abstract

The four principles of bioethics are in chronological order:
1/ the legal principle of justice;
2/ the Hippocratic principle of the primum non-nocere;
3/ the Christian principle of charity;
4/ the Kantian principle of the autonomy of the will.
In terms of these principles, surgery in general and plastic surgery in particular differ from medicine? I don't think so. But as in ancient theatre, if the actors remain the same, the masks change. The specificity of plastic and aesthetic surgery lies in a systematic work involving a form in the literal sense of the term. The issue can be 1/ functional (knee cover, mandibular reconstruction), 2/ almost always psychological (cosmetic surgery, disfigurement, victimology) or 3/ vital (necrotizing fasciitis). But in any case, what makes this surgical discipline unique is having to deal with a form that needs to be reconstructed or improved.
This singularity has been the source of great ethical debates in at least three areas:
1/ face transplant;
2/ cosmetic surgery;
3/ sexual conversion surgery.
We will clarify these questions in our presentation. Finally, this singularity inevitably illuminates ethical questioning in the field of medical research and pedagogy with a different day. I will clarify the state of reflection on the order of values in these two areas.