The article discusses fascinating points of similarity and difference between Leibniz's Monadology and Heidegger's 'The Thing', two of the greatest short works in the history of philosophy. But the key point of intersection between them is not widely recognised: indirect causation.

Evolution continually selects the best genes to proliferate the species. Emerging cosmetic plastic surgeries allow us to bypass our genetic code and cheat our naturally predetermined appearances by altering the perceived external flaws and ignoring the intact internal code where the “flaws” remain. Without these self-identified unwanted physical attributes, people who otherwise might not have been perceived as desirable mates for procreation allow themselves to be perceived as desirable enough to pass on their genes. TV shows are allowing us (...) to witness the advantages over evolution that can be gained with the right amount of time and money. What we see on the outside is not necessarily what we are going to get on the inside, genetically speaking. With more and more people flocking to cosmetic procedures at younger ages, doctors and consumers need to understand and discuss the importance of this dramatic misrepresentation to the opposite sex. While there is a right to undergo the procedures, those who do so prior to having children, and even those who do not, are faced with important affective choices within a number of different relationships that need to be considered for both now and the future. (shrink)

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 ], we argue that the patient needs to experience some degree of suffering, 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. (shrink)

Why do physicians who've taken the Hippocratic Oath willingly cut into seemingly healthy patients? How do you measure the success of surgery aimed at making someone happier by altering his or her body? Sander L. Gilman explores such questions in Creating Beauty to Cure the Soul, a cultural history of the connections between beauty of body and happiness of mind. Following these themes through an impressive range of historical moments and players, Gilman traces how aesthetic alterations of the body have (...) been used to "cure" dissatisfied states of mind. In his exploration of the striking parallels between the development of cosmetic surgery and the field of psychiatry, Gilman entertains an array of philosophical and psychological questions that underlie the more practical decisions rountinely made by doctors and potential patients considering these types of surgery. While surveying and incorporating the relevant theories of Sigmund Freud, Alfred Adler, Karl Menninger, Paul Schilder, contemporary feminist critics, and others, Gilman considers the highly unstable nature of cultural notions of health, happiness, and beauty. He reveals how ideas of race and gender structured early understandings of aesthetic surgery in discussions of both the "abnormality" of the Jewish nose and the historical requirement that healthy and virtuous females look "normal," thereby enabling them to achieve invisibility. Reflecting upon historically widespread prejudices, Gilman describes the persecutions, harrassment, attacks, and even murders that continue to result from bodily difference and he encourages readers to question the cultural assumptions that underlie the increasing acceptability of this surgical form of psychotherapy. Synthesizing a vast body of related literature and containing a comprehensive bibliography, Creating Beauty to Cure the Soul will appeal to a broad audience, including those interested in the histories of medicine and psychiatry, and in philosophy, cultural studies, Jewish cultural studies, and race and ethnicity. (shrink)

The market for cosmetic surgery tourism is growing with an increase in people travelling abroad for cosmetic surgery. While the reasons for seeking cosmetic surgery abroad may vary the most common reason is financial, but does cheaper surgery abroad carry greater risks? We explore the risks of poorly regulated cosmetic surgery to society generally before discussing how harm might be magnified in the context of cosmetic tourism, where the demand for cheaper surgery drives the market and makes surgery accessible for (...) increasing numbers of people. This contributes to the normalisation of surgical enhancement, creating unhealthy cultural pressure to undergo invasive and risky procedures in the name of beauty. In addressing the harms of poorly regulated surgery, a number of organisations purport to provide a register of safe and ethical plastic surgeons, yet this arguably achieves little and in the absence of improved regulation the risks are likely to grow as the global market expands to meet demand. While the evidence suggests that global regulation is needed, the paper concludes that since a global regulatory response is unlikely, more robust domestic regulation may be the best approach. While domestic regulation may increase the drive towards foreign providers it may also have a symbolic effect which will reduce this drive by making people more aware of the dangers of surgery, both to society and individual physical wellbeing. (shrink)

The concept of ‘accounts’ (Scott and Lyman, 1968) – or linguistic strategies for neutralizing the negative social meanings of norm violation – has a long history in sociology. This work examines British and American women's accounts of cosmetic surgery. In the medical literature, feminist writings and the popular press, aesthetic plastic surgery has been associated with narcissism, psychological instability and self-hatred. Given these negative connotations, cosmetic surgery remains a practice requiring justification even as its popularity increases. Drawing on interview (...) data, I argue that respondents' efforts to account for cosmetic surgery vary according to the ‘repertoires of evaluation’ (Lamont and Thévenot, 2000) made available by their own nation and, particularly, by its healthcare culture. In the market-based US healthcare system, women justify cosmetic surgery by referring to their personal and financial ‘investments’ in physical attractiveness and well-being. Such explanations are less legitimate in Britain, where healthcare is considered a social right rather than a consumer good. In the latter context, women employ narratives that medicalize the pre-surgical body by stressing the physical pain and emotional distress that it caused. (shrink)

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 individual’s 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 patients’ 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 patients’ 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 patients’ autonomy. We further suggest that if living organ donation valued donors’ autonomy as much as cosmetic plastic surgery does, we might witness a wider acceptance of and increase in living organ donation. (shrink)

The metaphor of inscription on the body and the constitution of the body through those inscriptions have been widely used in recent attempts to theorize the body. Michel Foucault calls the body the ‘inscribed surface of events’ (Foucault, 1984: 83) and Elizabeth Grosz argues that the ‘female (or male) body can no longer be regarded as a fixed, concrete substance, a pre-cultural given. It has a determinate form only by being socially inscribed’ (Grosz, 1987: 2). The body becomes plastic, (...) inscribed with gender and cultural standards. While Foucault assumes the existence of a pre-inscriptive body, many theorists reject that idea and argue that ‘there is no recourse to a body that has not always already been interpreted by cultural meanings’ (Butler, 1990: 8). The constitution of the body rests in its inscription; the body becomes the text which is written upon it and from which it is indistinguishable. Starting from Catherine Belsey's suggestion that to ‘give the metaphor literal significance … is to … isolate it for contemplation’ (Belsey, 1988: 100), I discuss this metaphor of inscription, using cosmetic surgery as one literal example. While some theorists reject the pre-inscriptive body, the popular discourses advocating changing one's body assume unproblematically the existence of a body prior to these ‘elective’ procedures and reinforce the mind/body dualism which recent theory has sought so insistently to reject. I examine how popular discourses of body modification enforce a disciplinary regime (in Foucault's sense) and impose degrees of both literal and figurative inscription. Juxtaposing these two perspectives, I explore how both discourses efface the materiality of the body and the social contexts within which bodies are experienced and constructed. While the rhetoric surrounding cosmetic surgery denies the physical process and the economic constraints, so theories of the body which stress the body's plasticity also deny the materiality of that process and the cultural and social contexts within which the body is always placed. (shrink)

When plastic surgeons meet with new cosmetic surgery clients, they routinely try to get patients to `sign up' for elective surgery without forcing or pressuring them to do it. On rare occasions, they face a prospective client who, in the course of interaction, signals possible legal or medical risks, thereby calling on the surgeon to screen the client more vigilantly to determine whether embarking on cosmetic surgery will be reasonable. Grounded against nine-month field work at a cosmetic surgery center, (...) combined with 30+ hours of videotaped data of initial consultations, this article investigates a unique situation in which a 74-year-old woman seeking rhinoplasty and rhytidectomy is perceived as a difficult customer. Why this moment was interpreted and emerged as difficult is the analytic focus of the article. Using action-implicative discourse analysis, the analysis describes five communication challenges the plastic surgeon faced in the course of the 60-minute encounter. In the article's conclusion, I reflect on what seems to be a central issue for plastic surgeons: to act as gatekeepers of a fully elective and pricy surgery in a service-oriented business. (shrink)

It is suggested that the practice of attempting to normalise children with Down 's syndrome by subjecting them to major facial plastic surgery has no therapeutic benefit, and should be seen as mutilating surgery comparable to female circumcision.

In the UK, female genital mutilation is unlawful, not only when performed on minors, but also when performed on adult women. The aim of our paper is to examine several arguments which have been advanced in support of this ban and to assess whether they are sufficient to justify banning female genital mutilation for competent, consenting women. We proceed by comparing female genital mutilation, which is banned, with cosmetic surgery, towards which the law has taken a very permissive stance. We (...) then examine the main arguments for the prohibition of the former, assessing in each case both (a) whether the argument succeeds in justifying the ban and, if so, (b) whether a parallel argument would not also support a ban on the latter. We focus on the following arguments. Female genital mutilation should be unlawful because: (1) no woman could validly consent to it; (2) it is an oppressive and sexist practice; (3) it involves the intentional infliction of injury; (4) it causes offence. Our view is that arguments (3) and (4) are unsound and that, although arguments (1) and (2) may be sound, they support not only a ban on female genital mutilation, but also one on (some types of) costmetic surgery. Hence, we conclude that the present legal situation in the UK is ethically unsustainable in one of the following ways. Either the ban on female genital mutilation is unjustified because arguments (1) and (2) are not in fact successful; or the law's permissive attitude towards cosmetic surgery is unjustified because arguments (1) and (2) are in fact successful and apply equally to female genital mutilation and (certain forms of) cosmetic surgery. The people of the countries where female genital mutilation is practised resent references to ‘barbaric practices imposed on women by male‐dominated primitive societies’, especially when they look at the Western world and see women undergoing their own feminization rites intended to increase sexual desirability: medically dangerous forms of cosmetic plastic surgery, for instance …. (shrink)

The aim of this article is to explore bodily changes following weight loss surgery. Our empirical material is based on individual interviews with 22 Norwegian women. To further analyze their experiences, we build primarily on the phenomenologist Drew Leder`s distinction between bodily dis-appearance and dys-appearance. Additionally, our analysis is inspired by Simone de Beauvoir, Merleau-Ponty and Julia Kristeva. Although these scholars have not directed their attention to obesity operations, they occupy a prime framework for shedding light on different dimensions of (...) bodily change. In doing so, we were able to identify two main themes: The felt “inner” body versus the visible “surface” body and the “old” body versus the “new” body. In different, though interconnected ways, these main themes encompass tensions between changes the women experienced as contributing to a more “normal” and active life, feeling more accepted, and changes that generated ambivalence. In particular, their skin became increasingly problematic because it did not “shrink” like the rest of the body. On the contrary, it became looser and looser. Moreover, badsmelling folds of skin that wobbled, sweated and chafed at the smallest movement, aprons of fat hanging in front of their stomachs, batwing arms, thick flabby thighs and sagging breasts were described as a huge contrast to the positive response they received to their changed body shape when they were out and about with their clothes on. At the same time, they expressed ambivalence with regards to removing the excess skin by means of plastic surgery. Through their own and other women`s experiences they learned removing the excess skin by means of surgery could be a double-edged sword. By illuminating the experiences of the ones undergoing such changes our article offers new insight in a scholarly debate predominated by medical research documenting the positive outcomes of weight loss surgery. (shrink)

Catholic health care institutions presently face the question of whether it would be morally legitimate for them to participate in sex reassignment surgery for patients suffering from gender dysphoria. This essay replies to two articles published on this question in the Winter 2016 issue of the Catholic health care journal Health Care Ethics USA. It argues that both articles fail to attend to factors necessary for an adequate moral assessment of the question, and thus provide inadequate solutions. It goes on (...) to argue that it would be intrinsically wrong for Catholic hospitals to counsel or perform sex reassignment surgery if in so doing they affirmed certain widely held erroneous assumptions about the nature of sex and gender. The essay ends by asking whether, if those erroneous assumptions were clearly and publically rejected, it could ever be licit to per­form surgical amputations or plastic surgical reconstructions to assist persons suffering from severe and intractable cases of gender dysphoria. (shrink)

BackgroundRespect for confidentiality is important to safeguard the well-being of patients and ensure the confidence of society in the doctor-patient relationship. The aim of our study is to examine real situations in which there has been a breach of confidentiality, by means of direct observation in clinical practice.MethodsBy means of direct observation, our study examines real situations in which there has been a breach of confidentiality in a tertiary hospital. To observe and collect data on these situations, we recruited students (...) enrolled in the Medical Degree Program at the University of Cordoba. The observers recorded their entries on standardized templates during clinical internships in different departments: Internal Medicine; Gynecology and Obstetrics; Pediatrics; Emergency Medicine; General and Digestive Surgery; Maxillofacial Surgery; Plastic Surgery; Orthopedics and Traumatology; Digestive; Dermatology; Rheumatology; Mental Health; Nephrology; Pneumology; Neurology; and Ophthalmology.ResultsFollowing 7138 days and 33157 h of observation, we found an estimated Frequency Index of one breach per 62.5 h. As regards the typology of the observed breaches, the most frequent were related to the consultation and/or disclosure of clinical and/or personal data to medical personnel not involved in the patient’s clinical care, as well as people external to the hospital. As regards their severity, severe breaches were the most frequent, accounting for 46.7 % of all incidents. Most of the reported incidents were observed in public areas, such as corridors, elevators, the cafeteria, stairs, and locker rooms.ConclusionsIn addition to aspects related to hospital organization or infrastructure, we have shown that all healthcare personnel are involved in confidentiality breaches, especially physicians. While most are committed unintentionally, a non-negligible number are severe, repeated breaches, thus suggesting a certain carelessness, perhaps through ignorance about certain behaviors that can jeopardize patient confidentiality. (shrink)

Über Jahrhunderte hatten Ärzte die Aufgabe, Krankheiten zu verhindern und zu behandeln. Nun stehen sie immer häufiger im Dienst der Selbstverwirklichung und Lebensplanung gesunder Menschen, besonders in der Fortpflanzungsmedizin und der ästhetischen Chirurgie. Welche Konsequenzen hat dies für die Zukunft der Medizin? Die Autoren beleuchten diesen Wandel von der krankheitsbekämpfenden zur wunscherfüllenden Medizin unter ärztlichen, rechtlichen und ethischen Aspekten.

Annelie Ramsbrock schreibt eine Geschichte der künstlich gestalteten Schönheit vom Ende der Aufklärung bis zum Beginn des Nationalsozialismus. Dabei verdeutlicht sie, dass die Ausbildung von Schönheitsidealen immer grundlegenden gesellschaftlichen Ordnungsmustern unterlag. Zum einen zeigt sich in Bereichen wie der Schönheitschirurgie oder der Herstellung von Kosmetika die Entwicklung des naturwissenschaftlichen Wissens. Zum anderen boten korrigierte Körper eine Projektionsfläche für soziale Ordnungsvorstellungen. Indem die Geschichte der Schönheit sowohl als eine Geschichte des Wissens als auch des Wertens gedacht wird, stellt die Autorin nicht (...) zuletzt den 'Mythos Schönheit' zur Disposition. (shrink)

This article seeks to examine how religious ideas that are not the focus of a particular halakhic question become the crux of the ruling, thereby molding it and dictating its bias. We will attempt to demonstrate this through a study of Jewish medical ethics, based on some of the rulings of one of the greatest halakhic decisors of the previous generation: Rabbi Eliezer Yehuda Waldenberg (1915–2006). Rabbi Waldenberg molds his rulings on the basis of a religious principle asserting that the (...) legitimacy of any medical procedure is qualified and limited. Rabbi Waldenberg rejects certain accepted medical practices, including plastic surgery, in vitro fertilization, and organ transplants. Even if these procedures are regarded by other halakhic decisors as being legitimate, for Rabbi Waldenberg they are ethically and religiously improper, and therefore they are halakhically forbidden. (shrink)

In liberal moral theory, interfering with someone’s deliberate engagement in a self-harming practice in order to promote their own good is often considered wrongfully paternalistic. But what if self-harming decisions are the product of an oppressive social context that imposes harmful norms on certain individuals, such as, arguably, in the case of cosmetic breast surgery? Clare Chambers suggests that such scenarios can mandate state interference in the form of prohibition. I argue that, unlike conventional measures, Chambers’ proposal recognises that harmful, (...) discriminatory norms entail a twofold collective moral obligation: to eliminate the harmful norm in the long run, but also to address unjust harm that is inflicted in the meantime. I show that these two obligations tend to pull in opposite directions, thus generating a serious tension in Chambers’ proposal which eventually leads to an undue compromising of the second obligation in favour of the first. Based on this discussion, I develop an alternative proposal which, instead of prohibiting breast implant surgery, offers compensation for the disadvantages suffered by individuals who decide not to have surgery. (shrink)

Scapula mobility complicates upper extremity kinematics assessment. Existing methods are diverse, providing inconsistent results. The current gold standard (bone pins) is prohibitively invasive. The purposes of the current study are to describe a virtual projection alternative to surface markers for video motion capture (VMC) of the scapula and to compare the results of the projection and surface marker methods to the results of similar existing methods. Ten participants were evaluated using VMC. Surface markers were applied to the trunk and arm (...) in accordance with existing guidelines. Three markers were affixed to plastic base on the skin over the acromion process. Other scapular landmarks were digitized in a neutral position. These landmarks’ locations were defined in reference to the acromion cluster and used to generate the projection. Humerothoracic, glenohumeral, and scapulothoracic kinematics were evaluated during shoulder abduction, flexion, and scaption. Joint angles produced by the surface markers and the projection were compared by Bonferroni-adjusted t tests. The results were compared to prior findings in the literature. The projection resulted in greater scapulothoracic upward rotation, internal rotation, and anterior–posterior tilt and less glenohumeral elevation (p <.0055) than did surface markers. The virtual scapula produced greater estimates of scapular mobility than did surface markers, corresponding to pre-existing results from similar methodologies. The result is a noninvasive measurement tool that produces different and superior results than do scapula surface markers. Measuring scapula kinematics via VMC without bone pins will facilitate future investigations into interactions between upper extremity injury, kinematics, and activity performance. (shrink)

This article examines whether cosmetic interventions by dentists and plastic surgeons are medically indicated and, hence, qualify as medical interventions proper. Cosmetic interventions (and the business strategies used to market them) are often frowned upon by dentists and physicians. However, if those interventions do not qualify as medical interventions proper, they should not be evaluated using medical-ethical norms. On the other hand, if they are to be considered medical practice proper, the medical-ethical principles of nonmaleficence, beneficence, justice and others (...) hold true for cosmetic interventions as much as they do for other medical and dental interventions. It is concluded that most cosmetic interventions do not qualify as medical interventions proper because they do not restore or maintain the patient's health (defined as the patient's integrity) by any objective standards. Rather, cosmetic interventions are intended to enhance a person's physical appearance; more specifically, they intend to fulfill the client's subjective perception of an enhanced appearance. (shrink)

Testa and colleagues argue that evaluation for suitability for living donor surgery is rooted in paternalism in contrast with the evaluation for most operative interventions which is rooted in the autonomy of patients. We examine two key ethical concepts that Testa and colleagues use: paternalism and autonomy, and two related ethical concepts, moral agency and shared decision making. We show that moving the conversation from paternalism, negative autonomy and informed consent to moral agency, relational autonomy and shared decision making, one (...) better understands why the arguments give by Testa and colleagues fail. (shrink)

Physiotherapy raises serious bioethical questions that are far too little discussed. Concerns include the lack of a clearly defined end point, the closeness of interaction between therapist and patient, the patient’s own share of responsibility, and the common failure to refer patients for rehabilitation.Physiotherapy has evolved dramatically in recent years, to the point where it is now a major healthcare profession offering assessment, diagnosis and treatment for a wide range of conditions, from sports injuries to rehabilitation for major injuries and (...) diseases. According to the World Confederation for Physical Therapy, “Physical Therapy is providing services to people and populations to develop maintain and restore maximum movement and functional ability throughout the lifespan” .1However, almost uniquely among the healthcare professions, physiotherapy has aroused little or no philosophical interest or engagement. This is surprising, because some of the salient features of physiotherapy raise interesting and to some extent novel problems in ethics. There are, it is true, some papers on ethically related themes,2–5 but in comparison with the size of the discipline and the complexity of the problems, the profile of physiotherapy in bioethics is worryingly low.A first problem is that unlike many areas of medicine—surgery, for example, or radiography or obstetrics and gynaecology—physiotherapy has no obvious end point. In medicine, the end points of treatment are generally well defined, with only a few exceptions, such as plastic surgery or psychiatry. It is my impression that physiotherapy, with few exceptions, does not operate with the concept of end points. Although what physiotherapy aims at is clear, the point at which the aims are achieved is uncertain. For example, in many cases the patient would go on benefiting from sessions of physiotherapy, perhaps with diminishing returns but still with …. (shrink)

Human enhancement has emerged in recent years as a blossoming topic in applied ethics. With continuing advances in science and technology, people are beginning to realize that some of the basic parameters of the human condition might be changed in the future. One important way in which the human condition could be changed is through the enhancement of basic human capacities. If this becomes feasible within the lifespan of many people alive today, then it is important now to consider the (...) normative questions raised by such prospects. The answers to these questions might not only help us be better prepared when technology catches up with imagination, but they may be relevant to many decisions we make today, such as decisions about how much funding to give to various kinds of research. Enhancement is typically contraposed to therapy. In broad terms, therapy aims to fix something that has gone wrong, by curing specific diseases or injuries, while enhancement interventions aim to improve the state of an organism beyond its normal healthy state. However, the distinction between therapy and enhancement is problematic, for several reasons. First, we may note that the therapy-enhancement dichotomy does not map onto any corresponding dichotomy between standard-contemporary-medicine and medicineas-it-could-be-practised-in-the-future. Standard contemporary medicine includes many practices that do not aim to cure diseases or injuries. It includes, for example, preventive medicine, palliative care, obstetrics, sports medicine, plastic surgery, contraceptive devices, fertility treatments, cosmetic dental procedures, and much else. At the same time, many enhancement interventions occur outside of the medical framework. Office workers enhance their performance by drinking coffee. Make-up and grooming are used to enhance appearance. Exercise, meditation, fish oil, and St John’s Wort are used to enhance mood. Second, it is unclear how to classify interventions that reduce the probability of disease and death.. (shrink)

Fashion is at once a familiar yet mysteriously elite world that we all experience, whether we’re buying a new pair of jeans, reading _Vogue_, or watching the latest episode of _Project Runway_. Lars Svendsen dives into that world in _Fashion_, exploring the myths, ideas, and history that make up haute couture, the must-have trends over the centuries, and the very concept of fashion itself. _Fashion _opens with an exploration of all the possible meanings encompassed by the word “fashion,” as Svendsen (...) probes its elusive place in art, politics, and history. Ultimately, however, he focuses on the most common use of the term: clothing. With his trademark dry wit, he deftly dismantles many of the axioms of the industry and its supporters. For example, he points out that some of the latest fashions shown on runways aren’t actually “fashionable” in any sense of the word, arguing that they’re more akin to modern art works, and he argues against the increasingly prevalent idea that plastic surgery and body modification are part of a new wave of consumerism. Svendsen draws upon the writings of thinkers from Adam Smith to Roland Barthes to analyze fashion as both a historical phenomenon and a philosophy of aesthetics. He also traces the connections between the concepts of fashion and modernity and ultimately considers the importance of evolving fashions to such fields as art, politics, and philosophy. Whether critiquing a relentless media culture that promotes perfect bodies or parsing the never-ending debate over the merits of conformity versus individual style, Lars Svendsen offers an engaging and intriguing analysis of fashion and the motivations behind its constant pursuit of the new. (shrink)

English summary: Medicine is not only a technique or skill for obtaining or restoring health in the face of illness and death; it strives to be a component of life that has learned to deal with the inevitability of suffering and death. As meditatio vitae et mortis, it can become a field of reflection on being human par excellence. The increasing possibility of anti-aging, plastic surgery and enhancement procedures, however, again bring about questions of the limits of human medicine, (...) even moreso if, as in transhumanist utopia and cryonic practice, the possibility of postponement or even of overcoming human finitude becomes possible. Medicine, society and the presence of death and dying must respond to these challenges. Herein ies the focus of this volume: the authors reflect on finiteness and immortality in medicine from historical, philosophical, social science, and ethical perspectives. German text. German description: Die Medizin ist nicht nur Technik oder Kunst, das Leben und die Gesundheit angesichts von Krankheit und Tod zu erhalten bzw. wiederherzustellen, sondern strebt eine Praxis der Lebensfuehrung an, die mit der Unvermeidbarkeit von Leiden und Sterben umzugehen lernt. Als meditatio vitae et mortis kann sie zu einem Feld der Reflexion ueber das Menschsein par excellence werden. Die zunehmenden Moglichkeiten von Anti-Aging, Plastischer Chirurgie und Enhancement stellen dabei die Fragen nach Grenzen einer humanen Heilkunde wieder neu, noch dazu, wenn - wie in transhumanistischen Utopien und kryonischer Praxis - die Moglichkeit der Verschiebung oder gar Uberwindung menschlicher Endlichkeit in Aussicht gestellt wird. Medizin, Gesellschaft und Sterbekultur der Gegenwart muessen auf die Herausforderungen reagieren. In diesem Themenfeld liegt der Schwerpunkt des Bandes: Die Autoren reflektieren Endlichkeit und Unsterblichkeit in der Medizin aus historischer, philosophischer, sozialwissenschaftlicher wie auch ethischer Perspektive. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.3 (2003) 104-107 [Access article in PDF] Motivating Aesthetics Cynthia C. Rostankowski Humanities Department San Jose State University The territory of philosophical aesthetics remains a conceptual hinterland in the world of academic disciplines. It is not the only hinterland, but in comparison to other disciplines in arts and letters, few scholars engage in the subject professionally, and many people avoid the territory it occupies (...) as a place to visit, let alone to tarry or reside. Why is this? Usually people do not wish to visit places that are uncomfortable in some way. Frozen wastelands, blazing deserts, war zones, and places with nothing to do or see are usually avoided because they are perceived as unpleasant, dangerous, or boring,and the same is very likely true of their conceptual analogs. In what senses might some people perceive aesthetics as analogous to Siberia, Sudan, or central Kansas? I would like to investigate what it is about aesthetics that causes people to shy away from it more often than to flock to it. I have long been fascinated by the responses of students who express amazement or confusion when exposed to the field of aesthetics as a part of an introductory philosophy class, or of arts educators who do not know what to do with aesthetics since it does not seem quite to fit with the rest of what they do, or the responses of some artists or other arts practitioners who are occasionally disdainful of aesthetics. It would be easy to say that aesthetics has merely had bad press or inadequate exposure in the classroom, but I suspect there is more to it than that. I have experienced many of the situations I have just mentioned, and they have usually surprised and sometimes demoralized [End Page 104] me. They have always motivated me to think harder about my beloved field of interest, to try to reveal its attractions to those who do not find it as appealing and engaging as I do, or as you, my reader does. (I am presuming that one who is reading an essay in a journal about aesthetic education has already found his or her comfort zone in the field.) I will also presume to offer some thoughts about motivating an interest in aesthetics among the aesthetically uninterested — why one might want to do it, and what one might do. Please note, I am not speaking of the aesthetically disinterested 1 ; they too have already found their place in the discipline!It is likely that the problem of aesthetics has to do in part with misunderstandings, and those misunderstandings are multi-layered. If one looks up the word "aesthetic" in the Oxford English Dictionary, one finds the following: (F)rom the Greek for perception...and, being pre-occupied;...pertaining to things perceptible by the senses, things material;..."criticism of taste"...the science which treats of the conditions of sensuous perception...of or pertaining to the appreciation or criticism of the beautiful...Recent extravagances in the adoption of a sentimental archaism as the ideal of beauty have still further removed aesthetic and its derivatives from their etymological and purely philosophical meaning. There are varied suggestions about the use of the term, including the mention of its removal in contemporary parlance from its original meanings. If one looks up the keyword "aesthetic" on the Internet, one may find the following sites: skin care, plastic surgery, dentistry, exterior and interior design, tattoos, and some art, art theory, and philosophy among other things. An exemplification in practice of what is suggested in the OED. It is clear that the meaning of the word "aesthetic" has become at best imprecise, at worst confusing in common parlance.So, the first misunderstanding regarding aesthetics is the meaning of the term. What is philosophical aesthetics? It is not what some misconstrue as the imposition of value judgments on society. Unfortunately, some presume that because matters of taste or definitions of beauty are considered in the field, someone must be telling someone what they ought to think is pleasing or beautiful. This is not the focus... (shrink)

Corporeality, Medical Technologies and Contemporary Culture engages the confusions and contradictions in current attitudes to, and practices of, the body. On the one hand, the body is where we turn for the certainties of nature; yet, on the other, it is the locus of a desire for permanent transformation and for constant reinvention. The body is at the same time worshipped and despised: so that now it has come to constitute not just an object of desire, but an object of (...) design. Addressing practices of corporeal ascesis- such as bodybuilding and dietetics - medical technologies - such as plastic surgery, prosthetics, and pharmacological interventions - and radical anatomical modifications- such as voluntary amputations, Francisco Ortega analyses how the body has become a screen for the projection of our ideas and imaginings about ourselves; and has also been turned into an object of suspicion, fear, anxiety, insecurity and discomfort. From the disembodied ideal of the digital purity of models - in which every little piece of fat is digitally eliminated - through the disembodiment implicit in social constructivist rejections of materiality, to the various projects of virtual reality, artificial intelligence, and posthumanism, Corporeality, Medical Technologies and Contemporary Culture documents the ambiguous legacy of a western theoretical tradition that has always despised the body. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.3 (2003) 104-107 [Access article in PDF] Motivating Aesthetics Cynthia C. Rostankowski Humanities Department San Jose State University The territory of philosophical aesthetics remains a conceptual hinterland in the world of academic disciplines. It is not the only hinterland, but in comparison to other disciplines in arts and letters, few scholars engage in the subject professionally, and many people avoid the territory it occupies (...) as a place to visit, let alone to tarry or reside. Why is this? Usually people do not wish to visit places that are uncomfortable in some way. Frozen wastelands, blazing deserts, war zones, and places with nothing to do or see are usually avoided because they are perceived as unpleasant, dangerous, or boring,and the same is very likely true of their conceptual analogs. In what senses might some people perceive aesthetics as analogous to Siberia, Sudan, or central Kansas? I would like to investigate what it is about aesthetics that causes people to shy away from it more often than to flock to it. I have long been fascinated by the responses of students who express amazement or confusion when exposed to the field of aesthetics as a part of an introductory philosophy class, or of arts educators who do not know what to do with aesthetics since it does not seem quite to fit with the rest of what they do, or the responses of some artists or other arts practitioners who are occasionally disdainful of aesthetics. It would be easy to say that aesthetics has merely had bad press or inadequate exposure in the classroom, but I suspect there is more to it than that. I have experienced many of the situations I have just mentioned, and they have usually surprised and sometimes demoralized [End Page 104] me. They have always motivated me to think harder about my beloved field of interest, to try to reveal its attractions to those who do not find it as appealing and engaging as I do, or as you, my reader does. (I am presuming that one who is reading an essay in a journal about aesthetic education has already found his or her comfort zone in the field.) I will also presume to offer some thoughts about motivating an interest in aesthetics among the aesthetically uninterested — why one might want to do it, and what one might do. Please note, I am not speaking of the aesthetically disinterested 1 ; they too have already found their place in the discipline!It is likely that the problem of aesthetics has to do in part with misunderstandings, and those misunderstandings are multi-layered. If one looks up the word "aesthetic" in the Oxford English Dictionary, one finds the following: (F)rom the Greek for perception...and, being pre-occupied;...pertaining to things perceptible by the senses, things material;..."criticism of taste"...the science which treats of the conditions of sensuous perception...of or pertaining to the appreciation or criticism of the beautiful...Recent extravagances in the adoption of a sentimental archaism as the ideal of beauty have still further removed aesthetic and its derivatives from their etymological and purely philosophical meaning. There are varied suggestions about the use of the term, including the mention of its removal in contemporary parlance from its original meanings. If one looks up the keyword "aesthetic" on the Internet, one may find the following sites: skin care, plastic surgery, dentistry, exterior and interior design, tattoos, and some art, art theory, and philosophy among other things. An exemplification in practice of what is suggested in the OED. It is clear that the meaning of the word "aesthetic" has become at best imprecise, at worst confusing in common parlance.So, the first misunderstanding regarding aesthetics is the meaning of the term. What is philosophical aesthetics? It is not what some misconstrue as the imposition of value judgments on society. Unfortunately, some presume that because matters of taste or definitions of beauty are considered in the field, someone must be telling someone what they ought to think is pleasing or beautiful. This is not the focus... (shrink)

Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all (...) the Fregoli cases reported in the literature since the seminal Courbon and Fail paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery , misidentified many different strangers or only one, showed other symptoms , and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. (shrink)

Readers of Geczy's book are in for a wild ride. The lavishly illustrated narrative moves in broad strokes from the commedia dell'arte to cyborgs, with gross-out plastic surgery disasters and live sex dolls in between. The book's premise is simple: where humans once found their humanity in separating themselves from the artificial, in our current technologically infused age, humans want more than anything to become as artificial as possible. Geczy puts it simply: "In the humanist age, Pinocchio wanted to (...) become human; in the so-called post-humanist age, humans aspire to become Pinocchio". His examples are anything but simple, however. Arguing that in and around the 1980s, the move from "dolls imitating humans... (shrink)

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed (...) to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice. (shrink)

Lookism is a term used to describe discrimination based on the physical appearance of a person. We suppose that the social impact of lookism is a philosophical issue, because, from this perspective, attractive people have an advantage over others. The first line of our argumentation involves the issue of lookism as a global ethical and aesthetical phenomenon. A person’s attractiveness has a significant impact on the social and public status of this individual. The common view in society is that it (...) is good to be more attractive and healthier. This concept generates several ethical questions about human aesthetical identity, health, authenticity, and integrity in society. It seems that this unequal treatment causes discrimination, diminishes self-confidence, and lowers the chance of a job or social enforcement for many human beings. Currently, aesthetic improvements are being made through plastic surgery. There is no place on the human body that we cannot improve with plastic surgery or aesthetic medicine. We should not forget that it may result in the problem of elitism, in dividing people into primary and secondary categories. The second line of our argumentation involves a particular case of lookism: Melanie Gaydos. A woman that is considered to be a model with a unique look. (shrink)

Drug resistant epilepsy is one of the most complex, multifactorial and polygenic neurological syndrome. Besides its dynamicity and variability, it still provides us with a model to study brain-behavior relationship, giving cues on the anatomy and functional representation of brain function. Given that onset zone of focal epileptic seizures often affects different anatomical areas, cortical but limited to one hemisphere, this condition also let us study the functional differences of the left and right cerebral hemispheres. One lateralized function in the (...) human brain is emotional prosody, and it can be a useful ictal sign offering hints on the location of the epileptogenic zone. Besides its importance for effective communication, prosody is not considered an eloquent domain, making resective surgery on its neural correlates feasible. We performed an Electronic databases search (Medline and PsychINFO) from inception to July 2017 for studies about prosody in epilepsy. The search terms included “epilepsy,” “seizure,” “emotional prosody,” and “vocal affect.” This review focus on emotional prosody processing in epilepsy as it can give hints regarding plastic functional changes following seizures (preoperatively), resection (post operatively), and also as an ictal sign enabling the assessment of dynamic brain networks. Moreover, it is argued that such reorganization can help to preserve the expression and reception of emotional prosody as a central skill to develop appropriate social interactions. (shrink)

Shoot straight from the hip. Tell it like it is. Keep it real. We love these commands, especially in America, because they invoke what we love to believe: that there is an authentic self to which we can be true. But while we mock Tricky Dick and Slick Willie, we are inventing identities on Facebook, paying thousands for plastic surgeries, tuning into news that simply verifies our opinions. This is frontier forthrightness gone dreamy: reality bites, after all, and faith-based (...) initiatives trump reality-based ones, and becoming disillusioned is a downer. In his new book, part memoir, part cultural analysis, Keep It Fake: Inventing an Authentic Life, Eric G. Wilson clarifies this confusion. He draws on neuroscience, psychology, sociology, philosophy, art, film, literature, and his own life to explore the possibility that there's no such thing as unwavering reality. Whether our left brains are shaping the raw data of our right into fabulous stories, or we are so saturated by society's conventions that we're always acting out prefab scripts, we can't help but be phony. But are some fakes more real than others? Are certain lies true? In lively prose—honest, provocative, erudite, witty, wide-ranging (as likely to riff on Bill Murray as to contemplate Plato)—Keep It Fakeanswers these questions, uncovering bracing truths about what it means to be human and helping us turn our necessary lying into artful living. (shrink)

BackgroundIn gender-affirming medical care (GAMC), ethical challenges in decision-making are ubiquitous. These challenges are becoming more pressing due to exponentially increasing referrals, politico-legal contestation, and divergent normative views regarding decisional roles and models. Little is known, however, about what ethical challenges related to decision-making healthcare professionals (HCPs) themselves face in their daily work in GAMC and how these relate to, for example, the subjective nature of Gender Incongruence (GI), the multidisciplinary character of GAMC and the role HCPs play in assessing (...) GI and eligibility for interventions. Given the relevance and urgency of these questions, we conducted a qualitative study among HCPs providing GAMC to transgender adults in the Netherlands.MethodsIn this qualitative research, we conducted 11 semi-structured interviews between May 2020 and February 2021 with HCPs (six mental health professionals, two HCPs in endocrinology, two in plastic surgery, and one in nursing) working in two distinct GAMC settings. We purposively sampled for professional background and years of experience in GAMC. We analyzed our interview data using thematic analysis. As some respondents were more inclined to speak about what should or ought to be done to arrive at good or right decision-making, we identified both ethical challenges and norms. Furthermore, in our analysis, we differentiated between respondents’ explicit and implicit ethical challenges and norms and ascertained the specific context in which these challenges emerged.ResultsRespondents’ ethical challenges and norms centered on (1) dividing and defining decisional roles and bounds, (2) negotiating decision-making in a (multidisciplinary) team, and (3) navigating various decision-making temporalities. These themes arose in the context of uncertainties regarding (1) GAMC’s guidelines, evidence, and outcomes, as well as (2) the boundaries and assessment of GI.ConclusionsThis interview study provides detailed empirical insight into both the explicit and implicit ethical challenges that HCPs experience and their ethical norms regarding decision-making. It also describes how uncertainties and (implicit) normativities concerning GAMC and GI pre-structure the moral environment in which these challenges and norms manifest. We provide normative reflections and recommendations on handling these ethical challenges in a way that is sensitive to the context in which they arise. (shrink)

This article explores how race, sexual attractiveness and ‘female nature’ are biologised in plastic surgery. I situate this analysis in relation to recent debates over the limits of social constructionism and calls for more engagement with biology in feminist theory and science studies. I analyse not only how the biological is represented by biomedicine, but also how it is experienced by patients and, most problematically, how it is entangled with social constructions of beauty, race and female reproduction. Drawing on (...) ethnographic fieldwork conducted in Brazil, I focus on plastic surgery, but also analyse how this specialty is linked to Ob-Gyn and endocrinology. I argue that medical procedures instantiate a biologised model of beauty I call ‘bare sex’ (Edmonds, 2010) that is defined in terms of racial traits, anatomy, reproductive processes, hormones and ‘secondary sexual traits’. While this is a historically specific model, it is also one that is inscribed on patients, altering anatomy and physiological processes. It thus has the potential to create a biological self-awareness that cannot fully be accounted for by a social constructionist analysis. (shrink)