One Face of Beauty, One Picture of Health: The Hidden Aesthetic of Medical Practice

Abstract

Unrecognized presuppositions about patient appearance have become increasingly important in medicine, medical ethics and medical law. Symptoms of these historically conditioned assumptions include common ageism, aesthetic surgery, and litigation about 'wrongful life'. These phenomena suggest a societal intolerance for what is considered an 'abnormal' appearance. Among others, eighteenth-century artists and anatomists helped to set these twentieth-century precedents, actually measuring deviations of external traits to analogous deformations of the soul, and drawing moral conclusions from physiognomic measurements. Other eighteenth-century artists countered with pathognomy, recognizing that uneven physical features may indicate humanity, instead of character flaws. We suggest that there is an important and as yet unrecognized role played by visual and perceptual preferences in our judgments concerning normalcy and anomaly. We further suggest a shift away from our current fashion-magazine, youth-oriented aesthetic, and towards an aesthetic of imperfection. Physicians and medical students can be made aware of their historically conditioned reactions to 'abnormal' appearing patients by studying the understandings and methods with which artists have portrayed those who are considered deformed in appearance.

Stigma in Practice: Barriers to Health for Fat Women

“…The results of recommending treatment for a patient based on an assumption rather than a clinical examination and discussion vary from: mis-diagnosis, no diagnosis, fat, or health shaming, a disbelieving attitude, an undermining attitude, and triggering an aversion in the patient to further seeking medical care—which was discussed earlier (Stafford et al, 1989; Kreuter et al, 1997; Pausé, 2014). Another aspect of failed medical treatment is when medical professionals respond to a fat patient as if weight is the only factor in that patient's health assessment.…”

The Ethics of Pressure Sore Prevention and Treatment In The Elderly: A Practical Approach

“…Medicare and Medicaid should compensate nursing homes for effective preventive care and care of the early pressure sore. 2. The aesthetics of pressure sore appearance and feelings of discomfort and dissatisfaction should be explicitly recognized and discussed among health care team members 29 3.…”

“…2. The aesthetics of pressure sore appearance and feelings of discomfort and dissatisfaction should be explicitly recognized and discussed among health care team members 29 …”

The natural histories of bone dysplasias in adults—Vignettes, fables and just‐so stories

“…Secondly, social barriers (rather than medical issues) are often viewed as the more problematic. Social barriers range from subtle discriminatory attitudes (e.g., height correlates with social status and success [Gillis and Avis, 1980; Hensley and Cooper, 1987; Martel and Biller, 1987]), to the overt and blatant (e.g., that a person's physical attributes directly reflects the character of his or her soul [Stafford et al, 1989; Severgnini, 2006]). Decreased self esteem seems to be the most uniformly identified effect of dwarfism.…”