Cosmetic procedures: ethical issues

Over the past decade, there have been several official reviews of the regulation of the cosmetic procedures industry. In 2013, in a report commissioned by the Department of Health, Sir Bruce Keogh described aspects of the cosmetic procedures industry as “a crisis waiting to happen”.

The Keogh report made wide-ranging recommendations to improve the safety of those using both surgical and non-surgical invasive cosmetic procedures. While some of these recommendations have been followed through, concerns remain.

In particular:

• Controls on the safety of some of the products used in procedures remain inadequate
• Requirements for practitioners to have particular qualifications and experience are only voluntary
• It is still too difficult for anyone seeking a cosmetic procedure to find out whether a practitioner is appropriately qualified to carry out that procedure.

Moreover, the Keogh report explicitly chose “not [to make] judgements about whether the growth in cosmetic interventions is good or bad” but rather to focus on making what was already happening safer.

The Nuffield Council on Bioethics believes that the ethical concerns arising in connection with the growing proliferation, promotion, and use of invasive cosmetic procedures need more attention. In addition to the ongoing failure by governments to regulate to improve safety, we are concerned that none of the earlier reviews explored the potentially troubling reasons behind the growth in the popularity of invasive cosmetic procedures. This report considers the ethical aspects of the increasing demand for these procedures, as well as ethical questions about their supply.