Ethics of esthetic procedures in pregnancy.

Abstract

Ethical dilemmas arise when clinicians are faced with conflicting and mutually exclusive courses of action that create moral uncertainties (Beauchamp and Childress, 2001). Four ethical principles (respect for patient autonomy [i.e., respect patient’s preferences in medical care], beneficence [i.e., act in the best interests of the patient], nonmaleficence [i.e., do no harm; minimize risk to the patient], and justice [i.e., clinical intervention results in fair distribution of clinical benefits and burdens in a population]) form the foundation of modern bioethics (Beauchamp and Childress, 2001). In a systematic review of ethical principles in plastic surgery, autonomy was the most common theme (Chung et al., 2009). Cosmetic care is considered to be based on an individual’s autonomous right to seek to become more beautiful (Nejadsarvari et al., 2016). A resolution of ethical conflicts often requires prioritizing moral obligations through a process of shared decision making, negotiation, and thoughtful compromise (Mahowald, 2006). The aim of this article is to discuss ethical dilemmas related to esthetic procedures during pregnancy on the basis of evidence in support of the safety of such procedures during pregnancy. Ethical principles as applicable to mother and fetus and the concept of the fetus as a patient are discussed. Through the analysis of case scenarios, the article highlights reasons for ethical conflicts related to esthetic procedures during pregnancy, such as a lack of high-quality evidence.