Volume 23, Number 2, Summer 2012

Living Donation and Cosmetic Surgery: A Double Standard in Medical Ethics? 


Giuliano Testa, Erica Carlisle, Mary Simmerling, and Peter Angelos 


The Journal of Clinical Ethics 23, no. 2 (Summer 2012): 110-117. 


The commitment of transplant physicians to protect the physical and psychological health of potential donors is fundamental to the process of living donor organ transplantation. It is appropriate that strict regulations to govern an individualís decision to donate have been developed. Some may argue that adherence to such regulations creates a doctor-patient relationship that is rooted in paternalism, which is in drastic contrast with a doctor-patient relationship that is rooted in patientsí autonomy, characteristic of most other operative interventions.


In this article we analyze the similarities between cosmetic plastic surgery and living donor surgery as examples of surgeries governed by different ethical principles. It is interesting that, while the prevailing ethical approach in living donor surgery is based on paternalism, the ethical principle guiding cosmetic surgery is respect for patientsí autonomy. The purpose of this article is not to criticize either practice, but to suggest that, given the similarities between the two procedures, both operative interventions should be guided by the same ethical principle: a respect for patientsí autonomy. We further suggest that if living organ donation valued donorsí autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation.



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