“Big eye” surgery: the ethics of medicalizing Asian features

Aquino, Yves Saint James

doi:10.1007/s11017-017-9395-y

Cited by 24 publications

(34 citation statements)

References 18 publications

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“…Could the approach to this scenario open Pandora's box for debate as to what should be publicly financed? Many patients seek private plastic surgery due to an ethnically typical nose [60,61] or eyes [81]. However, if this 'ethnic' appearance is commonly represented in the population at large, it will not provide grounds for public funding.…”

Section: Opening Pandora's Box?mentioning

confidence: 99%

An ethics analysis of the rationale for publicly funded plastic surgery

Sandman

Hansson

2020

BMC Med Ethics

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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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Section: Opening Pandora's Box?mentioning

confidence: 99%

An ethics analysis of the rationale for publicly funded plastic surgery

Sandman

Hansson

2020

BMC Med Ethics

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“…The model of SDM as a transaction between practitioners as the providers of knowledge and the patient as a consumer of care is of course instantly intelligible to policymakers and managers, resonating with the dominant market ideology of our era . The dangers of regarding medical consumerism as the natural alternative to medical paternalism are also well recognized—see, for instance, Aquino's important work on “big‐eye surgery”, which suggests that we do not succeed in treating patients as persons simply by asking them “of the options available, what do you want?,” ignoring the broader cultural and economic context constraining their responses. As Pollner et al note, commercial interests will impact on the decision‐making process in ways that do not always directly consider the broader interests and values of patients or indeed the ethics and values of practitioners.…”

Section: Concluding Comments: Sdm and Person‐centred Practicementioning

confidence: 99%

Interactions between persons—Knowledge, decision making, and the co‐production of practice

Loughlin

Buetow

Cournoyea

et al. 2019

Evaluation Clinical Practice

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There is now broad agreement that ideas like person‐centred care, patient expertise and shared decision‐making are no longer peripheral to health discourse, fine ideals or merely desirable additions to sound, scientific clinical practice. Rather, their incorporation into our thinking and planning of health and social care is essential if we are to respond adequately to the problems that confront us: they need to be seen not as “ethical add‐ons” but core components of any genuinely integrated, realistic and conceptually sound account of healthcare practice. This, the tenth philosophy thematic edition of the journal, presents papers conducting urgent research into the social context of scientific knowledge and the significance of viewing clinical knowledge not as something that “sits within the minds” of researchers and practitioners, but as a relational concept, the product of social interactions. It includes papers on the nature of reasoning and evidence, the on‐going problems of how to ‘integrate’ different forms of scientific knowledge with broader, humanistic understandings of reasoning and judgement, patient and community perspectives. Discussions of the epistemological contribution of patient perspectives to the nature of care, and the crucial and still under‐developed role of phenomenology in medical epistemology, are followed by a broad range of papers focussing on shared decision‐making, analysing its proper meaning, its role in policy, methods for realising it and its limitations in real‐world contexts.

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“…Following Cela's story above, I focus here on surgeries that reduce the 'Asian jaw'. 17 Though a considerable amount of critical attention has been paid to the steadily growing demand for blepharoplasty (eyelid surgery) among Asian people (primarily women) (Aquino, 2017;Gilman, 1999;Heyes, 2009;Holliday and Elfving-Hwang, 2012;Kaw, 1993;Zane, 1998), relatively little has been paid to the bone reconstruction work performed on the 'Asian face'. The most invasive of these procedures involves the reduction and/or removal of the 'wide' and 'flared' mandible responsible for what is described in surgical literature as a distinctly Asian facial squareness.…”

Section: Celamentioning

confidence: 99%

“…The availability of body-altering techniques incites a 'cosmetic gaze' through which all bodies are seen as improvable through intervention (Wegenstein and Ruck, 2011). Some scholars focused on race, ethnicity, and facial cosmetic surgery have read the surgical consumption of non-white patients (usually women) as motivated by an aim of 'whitening' or 'Westernizing' their appearance, thereby reading surgical self-making as an embodied materialization of race, gender, class, and (post) colonial politics (Aquino, 2017;Davis, 2003b;Dull and West, 1991;Hunter, 2011;Kaw, 1993;Perry, 2006). Others have challenged the assumption that women of color use surgery in a distinctly different way than do white women (Gulbas, 2013;Pham, 2014), suggesting that to read all surgeries undertaken by non-white women as mimicry of a desired whiteness depends upon an assumption of 'whiteness' or 'Westernness' as an aesthetic ideal (Davis, 2003b;Heyes, 2009;Luo 2013;Zane, 1998), one that, as Holliday and Elfving-Hwang (2012) argue, is not available even to most white people.…”

mentioning

confidence: 99%

Gender, Ethnicity, and Transgender Embodiment: Interrogating Classification in Facial Feminization Surgery

Plemons

2018

Body & Society

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Facial feminization surgery (FFS) is a set of bone and soft tissue procedures intended to feminize the faces of transgender women. In the surgical evaluation, particular facial features are identified as 'sex specific' and targeted for intervention as such. But those features do not exhibit 'maleness' or 'femaleness' alone; they are complexly entwined with morphologies of ethnic classification. Based on clinical observation, I show how the desired feminine ideal conflicted with facial characteristics identified as 'ethnic'. In FFS practice, 'masculinity' and 'ethnicity' were entangled as the constitutive outsides by which desirable 'femininity' was articulated. I argue that surgery that self-consciously enacts a patient's move away from physiognomically identifiable ethnicity in order to achieve an ostensibly unmarked and neutral femininity becomes not only a process of feminizing the face but of whitening it, regardless of whether 'white' features are the express desire of the patient or aim of the surgeon.

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“Big eye” surgery: the ethics of medicalizing Asian features

Cited by 24 publications

References 18 publications

An ethics analysis of the rationale for publicly funded plastic surgery

An ethics analysis of the rationale for publicly funded plastic surgery

Interactions between persons—Knowledge, decision making, and the co‐production of practice

Gender, Ethnicity, and Transgender Embodiment: Interrogating Classification in Facial Feminization Surgery

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