An ethics analysis of the rationale for publicly funded plastic surgery

Abstract 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...

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Main Authors: Lars Sandman, Emma Hansson
Format: Article
Language:English
Published: BMC 2020-10-01
Series:BMC Medical Ethics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12910-020-00539-6
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author Lars Sandman
Emma Hansson
author_facet Lars Sandman
Emma Hansson
author_sort Lars Sandman
collection DOAJ
description Abstract 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 an absolute priority 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.
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spelling doaj.art-ffaf206e60824fd991ec576922cd9b752022-12-21T17:59:23ZengBMCBMC Medical Ethics1472-69392020-10-0121111410.1186/s12910-020-00539-6An ethics analysis of the rationale for publicly funded plastic surgeryLars Sandman0Emma Hansson1National Centre for Priorities in Health, Department of Health, Medicine and Caring Sciences, Linköping UniversityDepartment of Plastic and Reconstructive Surgery, Sahlgrenska University HospitalAbstract 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 an absolute priority 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.http://link.springer.com/article/10.1186/s12910-020-00539-6Plastic surgeryEsthetic surgeryRationingPrioritizingNormalityFunctional condition
spellingShingle Lars Sandman
Emma Hansson
An ethics analysis of the rationale for publicly funded plastic surgery
BMC Medical Ethics
Plastic surgery
Esthetic surgery
Rationing
Prioritizing
Normality
Functional condition
title An ethics analysis of the rationale for publicly funded plastic surgery
title_full An ethics analysis of the rationale for publicly funded plastic surgery
title_fullStr An ethics analysis of the rationale for publicly funded plastic surgery
title_full_unstemmed An ethics analysis of the rationale for publicly funded plastic surgery
title_short An ethics analysis of the rationale for publicly funded plastic surgery
title_sort ethics analysis of the rationale for publicly funded plastic surgery
topic Plastic surgery
Esthetic surgery
Rationing
Prioritizing
Normality
Functional condition
url http://link.springer.com/article/10.1186/s12910-020-00539-6
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