Hilhorst M T
Department of Medical Ethics, Faculty of Medicine and Health Care, Erasmus University, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
Med Humanit. 2002 Dec;28(2):61-5. doi: 10.1136/mh.28.2.61.
In the process of deciding to undergo cosmetic surgery for aesthetic reasons, people may err in various ways. Adolescents in particular run the risk of making errors, and both parents and surgeons have special moral responsibilities to avoid disappointments. Parents should face a number of moral issues; if they fail to do so, surgeons have a moral if not legal responsibility, to raise these issues and take a moral stand. In this paper, a number of pitfalls are specified from a philosophical perspective. A request for surgery should not be granted if patients do not meet the standards required for stable decision making and a balanced judgment, and particularly in those case where patients fail to understand the assumptions--in terms of human values--underlying the surgical intervention. Assessments of competence should go beyond formal conceptions of autonomy, and should, as will be shown, be made on an individual basis. Substantive questions of personal identity and identity formation, within the context of often rapid psychosocial development and emotional turmoil peculiar to adolescents, should be addressed. The key to the moral evaluation of this surgery therefore lies primarily in a patient's life story.
在出于审美原因决定接受整容手术的过程中，人们可能会以各种方式犯错。尤其是青少年面临犯错的风险，父母和外科医生都负有特殊的道德责任以避免失望。父母应该面对一些道德问题；如果他们未能做到，外科医生在道德上（即便不是法律上）有责任提出这些问题并表明道德立场。在本文中，从哲学角度明确了一些陷阱。如果患者不符合稳定决策和平衡判断所需的标准，特别是在那些患者不理解手术干预背后（从人类价值观角度）的假设的情况下，不应批准手术请求。能力评估应超越形式上的自主性概念，并且正如将要表明的，应在个体基础上进行。在青少年特有的快速心理社会发展和情绪动荡的背景下，应解决个人身份和身份形成的实质性问题。因此，对这种手术进行道德评估的关键主要在于患者的人生经历。
