Experts urge ethical debate as cosmetic procedures become the norm
Cosmetic interventions are expanding across the United States, and an increasing number of theologians and medical ethicists say ethical discussion about them has not kept pace with the speed at which they are entering everyday life. The Associated Press profiles people weighing procedures and experts arguing that questions about beauty, agency and medical priorities now need broader public attention.
Shula Jassell, a 25-year-old from Southern California, said she has thought about getting filler to make her chin bigger, but she also weighs the idea of repeatedly paying for treatments that last about a year. She described talking herself out of getting work done “for now,” saying, “I just try to remember self-love, you know? Beauty is in the eye of the beholder.” The AP report places her personal dilemma alongside the broader push to get younger-looking features through a growing mix of cosmetic options.
The AP report says technological changes and social media exposure have made body modification more accessible, with injectables, cosmetic plastic surgery and the diabetes and weight-loss drug Ozempic increasingly showing up in everyday routines and online feeds. As the interventions become more common—often, but not exclusively, marketed toward women—experts say the ethical questions shift from “whether” to “how” people should understand what they are choosing.
Natalie Carnes, a feminist theologian at Duke Divinity School, said in the AP report that the conversation should not place the “burden squarely on women” while also “not taking away their moral agency.” She also argued that beauty is both “good” and something people can pursue, but that Botox and Ozempic and face-lifts can function by narrowing “the cultural ideals of beauty.”
Religious guidance has been limited, the AP report says, but one major religious statement that drew attention came from the Vatican in March. In its document on Christian anthropology, the Vatican decried what it called a “cult of the body,” saying that once modified—often with “relentless frenzy”—the body becomes a “body-object” in which the person-subject mirrors themselves, creating a relationship in which the person is no longer “his or her body” but “owns” a body.
Demand, the AP report says, has also grown in the plastic surgery market itself. Dr. C. Bob Basu, president of the American Society of Plastic Surgeons, said that “forty years ago” some people believed cosmetic surgery was reserved for the superrich or celebrity elite, but he said that is no longer the case. He added that one of the biggest changes he has seen is more young people choosing interventions earlier—such as “baby Botox” to prevent wrinkles or considering a deeper face-and-neck lift in the late 30s or early 40s rather than waiting until the 60s.
Even as procedures become more common, some ethicists say medical training does not prepare clinicians to navigate the ethical issues. Arthur Caplan, founding head of the Division of Medical Ethics at NYU Grossman, told the AP that bioethics trainees often rotate through areas such as intensive care, palliative care and transplants, but “Nobody rotates to plastic surgery.” He argued that the lack of specialized ethical training can leave boundaries about what surgeons will and will not do to be set without the same depth of ethics education.
Across faiths, the AP report also describes different ways religious teachings can intersect with cosmetic choices. Dr. Jerry Chidester, a member of The Church of Jesus Christ of Latter-day Saints, said he sees a broad range of views within the church and pointed to the cultural landscape of Salt Lake City, where he is based. He told the AP he advises patients not to worry about what others think, saying, “I’m like, ‘Look, if you want to do this or not, it’s up to you,’” and adding that it is “literally your body. Who cares if they think you’re doing it for vanity or for function or whatever? It is none of their business.”
Dr. Sheila Nazarian, a Jewish board-certified plastic surgeon, said she incorporates her interpretations of parts of the Torah when thinking about when body modification is appropriate, telling the AP, “If it’s bringing distress, then it’s OK.” She said her patient population includes people who she described as adjusted and successful, but who want help with “one little thing that they’d just rather not think about anymore.”
The AP report also includes a Christian surgeon, Dr. Michael Obeng, who said acceptance of cosmetic procedures has increased over nearly 20 years of practice. He told the AP that “Now people are not even hiding it,” and described public display of plastic surgery as a “badge of honor,” adding that “We are aging slower” and working longer than “our moms and grandmothers worked.” Obeng said he rarely feels tension between his faith and his work and described how in 2018 he began thinking through his willingness to perform certain gender transition surgeries, seeking advice from pastors and religious leaders, before deciding to limit his practice to some gender-related procedures.
Other experts, the AP report says, focus on how personal choices can be constrained by social pressures and the way medicine and appearance are intertwined in culture. Ivory Kellogg, an actor in Los Angeles, described the expectation that at 35 people consider procedures such as a mini face-lift, while also saying she wants women to feel allowed to choose what they want. Sociologist Abigail Saguy, at UCLA, said that people should consider how choices are “constrained” and the “social pressures,” arguing that “This is a social issue” that is “continually treated as an individual issue.”
In cases where cosmetic interventions offer medical benefits, the AP report notes that questions remain when those uses expand beyond clinical need. Dr. Aasim Padela, who studies bioethics and Islamic thought at the Medical College of Wisconsin, told the AP that he thinks a broader conversation is needed, including the ways the field of medicine can be affected when cosmetic surgery is prioritized and how resources can be poorly distributed.