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An ethics analysis of the rationale for publicly funded plastic surgery
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.ORCID iD: 0000-0003-0987-7653
Department of Plastic and Reconstructive Surgery, Sahlgrenska University Hospital, Gröna Stråket 8, SE-413 45 Gothenburg, Gröna Stråket 8, SE-413 45, Gothenburg, Sweden.
2020 (English)In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 21, no 1Article in journal (Refereed) Published
Abstract [en]

Background Healthcare systems are increasingly struggling with resource constraints, given demographic changes, technological development, and citizen expectations. The aim of this article is to normatively analyze different suggestions regarding how publicly financed plastic surgery should be delineated in order to identify a well-considered, normative rationale. The scope of the article is to discuss general principles and not define specific conditions or domains of plastic surgery that should be treated within the publicly financed system. Methods This analysis uses a reflective equilibrium approach, according to which considered normative judgements in one area should be logically and argumentatively coherent with considered normative judgements and background theories at large within a system. Results and conclusions In exploring functional versus non-function conditions, we argue that it is difficult to find a principled reason for anabsolutepriority of functional conditions over non-functional conditions. Nevertheless, functional conditions are relatively easier to establish objectively, and surgical intervention has a clear causal effect on treating a functional condition. Considering non-functional conditions that require plastic surgery [i.e., those related to appearance or symptomatic conditions (not affecting function)], we argue that the patient needs to experience some degree of suffering (and not only a preference for plastic surgery), which must be ‘validated’ in some form by the healthcare system. This validation is required for both functional and non-functional conditions. Functional conditions are validated by distinguishing between statistically normal and abnormal functioning. Similarly, for non-functional conditions, statistical normality represents a potential method for distinguishing between what should and should not be publicly funded. However, we acknowledge that such a concept requires further development.

Place, publisher, year, edition, pages
2020. Vol. 21, no 1
Keywords [en]
Plastic surgery, Esthetic surgery, Rationing, Prioritizing, Normality, Functional condition, Psychosocial condition, Etiology, Healthcare need, Patient experience
National Category
Health Sciences Philosophy, Ethics and Religion
Identifiers
URN: urn:nbn:se:hb:diva-24810DOI: 10.1186/s12910-020-00539-6ISI: 000576912600002Scopus ID: 2-s2.0-85092269172OAI: oai:DiVA.org:hb-24810DiVA, id: diva2:1521885
Available from: 2021-01-25 Created: 2021-01-25 Last updated: 2021-10-20Bibliographically approved

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