Hippoccratic Oath

Confronting My Biases #30: Fake Puffy Lips

/ Jack Marshall / 14 Comments

More than 10 years ago I wrote about Kristina Rei, 22, of St. Petersburg, Russia. She wanted to look like Jessica Rabbit, the cartoon character, so she got herself a pair of huge—lips.She has undergone over 100 silicon-injection procedures, and considers it just the initial step in her quest to look like Roger Rabbit’s Toon wife from “Who Framed Roger Rabbit?”. ” At the time, I asked whether it ethical for a plastic surgeon to give her the ridiculous lips she coveted, since plastic surgeons are subject to the Hippocratic Oath like other doctors. My own position then and now, was that it is unethical, though I tried to give both sides of the issue.

“If Kristin can eat, drink and breathe with her mega-lips,” I wrote, “and there is no risk that they might explode, killing everyone near her, the decision to do what she wants is probably ethical, at least by medical ethics standards. The fact that her Chap-Stick costs will be astronomical is not the doctor’s concern, however.” Nevertheless, I concluded that “a plastic surgeon who assists a patient, especially one so young, in disfiguring herself to this extent is unethical. Autonomy is to be respected always, and beauty is in the eye of the beholder.  Kristin’s lips are so far beyond reason that a plastic surgeon debases his profession by assisting in what can fairly be called self-mutilation.”

My bias regarding fake puffy lips does not involve such extreme disfigurement; indeed most would agree that young women getting their lips puffed up isn’t disfiguring at all. However, it is increasingly becoming apparent to me that this particular form of supposedly aesthetic enhancement is becoming a norm, and a harmful one.

Continue reading →

Jessica Rabbit Ethics

/ Jack Marshall / 21 Comments

From Left: Jessica, Pixie Before, Pixie After

                          From Left: Jessica, Pixie Before, Pixie After

Who could have predicted, when “Who Framed Roger Rabbit?” opened in theaters, that one of its greatest legacies would be a continuing obsession of young women to emulate her exaggerated, uh, features? Yet here is another example—and there have been quite a few—of a woman mutilating herself in pursuit of looking like the sexy Toon.  Model Pixee Fox—I’m sure that’s her real name—wore a waist-training corset for 24 hours a day and spent $120,000 on various cosmetic procedures including a recent operation to have six of her ribs removed in order to achieve Jessica’s apparent 48-14-40 figure.

“I’ve always been inspired by cartoons and Disney movies, all the curves and tiny waists,” Fox told reporters. “People often, they come up to me and say, ‘Don’t take this the wrong way, but you look like a cartoon.’ For me that’s a compliment. My inspiration started with Tinkerbell, but with my transformation, I’ve been starting to look like Jessica Rabbit.”

If you say so, Pixee!  Pixee is ill, it’s fair to say, so the ethical issues fall on the shoulders of  Dr. Barry Eppley, the Indiana surgeon who admits handling Fox’s surgery and also defends it.

I covered this the last time Ethics Alarms covered a wannabe Mrs. Rabbit (Jessica is a human Toon married to a member Leporidae Family). In that case, the happy aspiring Toon looked like this when all was done…

Lips Continue reading →

Comment of the Day: “Three Breasted Ethics”

/ Jack Marshall / 15 Comments

Alexander Cheezem contributed an informative and well-argued comment challenging my ethical conclusions in the case of “Jasmine Tridevil,” who supposedly had a surgically constructed third breast attached between her two natural ones in an effort to become a reality TV star. Her story turned out to be a scam, but the ethical analysis is still worthy of consideration. Ethics Alarms doesn’t have many medical ethics dilemmas to ponder, and it is a fascinating area. As I considered  Jasmine’s titillation, I suspected it might be a hoax, but from the standpoint of honing ethics alarms, it doesn’t matter. I’m kind of relieved, frankly. Continue reading →

Three Breasted Ethics

/ Jack Marshall / 19 Comments

Three_breasted_woman

UPDATE: Snopes, the urban legend and hoax website, now thinks that this is a scam. As I noted in the post, that would not be a surprise and in fact would be a relief. In such cases, I suggest that the post be read as a hypothetical, since the ethics issues raised by the three-breasted woman remain interesting, even if the story itself turns out to be fiction.

A 21-year-old woman being identified with the alias Jasmine Tridevil ( don’t over-think it) says she paid $20,000 to a plastic surgeon to  give her a realistic third breast. She wants to  become a TV reality show star. Jasmine has hired a camera crew to follow her around Tampa, Florida, documenting the challenges she faces as a three-breasted woman.

I know what you are thinking.

I HOPE this is a hoax.

“Jasmine” was rejected by more than 50 doctors who believed they would be violating professional ethical codes. Scot Glasberg, president-elect of the American Society of Plastic Surgeons, condemned the surgery as ‘worse than unethical’ and ‘harmful to society’. ‘This violates every ethical principle not just in surgery but in medicine as well. We look to enhance the norm. This is not the norm. Nothing speaks louder than the fact that the surgeon required the patient to sign a non-disclosure form.” Continue reading →

Post-Thanksgiving Ethics Quiz: Is This Ethical? (Giant Lips Edition)

/ Jack Marshall / 13 Comments

Jessica also apparently has only one eye…

Look at the bright side: at least she didn’t have octuplets.

Kristina Rei, 22, of St. Petersburg, Russia, wants to look like Jessica Rabbit, so naturally she opted to get herself a pair of huge—lips.She has undergone over 100 silicon-injection procedures, and considers it just the initial step in her quest to look like Roger Rabbit’s

Kristin’s hickies are deadly.

Toon wife from “Who Framed Roger Rabbit?”. “When I can afford it I want to enlarge my breasts from a C-cup to a DD, change the shape of my nose and I want to make my ears pointed like an elf,” she told reporters. “It’s good to be different.”

Well, she’s different, all right.

Your Post-Thanksgiving Ethics Quiz: Was it ethical for a plastic surgeon to give her the lips she wanted?

Plastic surgeons are subject to the Hippocratic Oath like other doctors, but in  cases of elective surgery the standards of what constitutes doing substantive harm to a patient are extremely elastic. None of the Codes of Ethics for plastic surgeons would clearly prohibit giving a patient lips that look like they belong on a Macy’s helium balloon, or similar exaggerated features. These lips make Kristina happy. Is she mentally ill? A doctor who suspected so would be wrong to submit to her wishes if they were based on clinically defective judgment, but the fact that a doctor thinks a patient will look like a freak if he does what she wants isn’t ethically dispositive. Continue reading →