Ethics can be difficult to define in simple terms. When reviewing both the Merriam-Webster and Oxford dictionaries, both referred to morals and separately referred to moral duty and obligation and moral principles that governed a person’s behavior.
Ethics can be governed by many different things, all of which can vary. These variables can range from laws, traditions, culture, religion, politics, to social standards and other avenues.
Medical ethics can be construed as a bridge between theoretical bioethics and bedside practice. As may patients relay their medical secrets to physicians, it is the physician’s duty to act ethically in all situations. Physicians have a self-imposed code of conduct, accepted voluntarily within the medical professions, the observance of which depends on one’s conscience and moral values.
In terms of laws and medical ethics, physicians must follow the law. However, there is a fluid dynamic with the law and medical ethics as they tend to change over time, place, religion, culture, and personal conscience.
Over the past several years, spas have begun to incorporate medical “procedures”. However, there are rarely any medically qualified personnel present to perform or answer questions for patients. Paramedical professionals may be present with some knowledge but often times, non-medical trained personnel work in spas. They may be well-trained in their area, but they lack any medical knowledge or may be certified only after basic training. However, many of these personnel behave as doctors and diagnose, provide advice, and perform procedures.
Patient safety should be first and foremost in all situations. For these reasons, spas should meet medical criteria for employment. In addition, physicians should play an active role in spas to meet, listen, evaluate, advise, plan, perform, and supervise non-medical staff as well as be certified from a respectable authority.
Pricing is an important factor. However, lowering prices and “sales” can lead to decreased revenue, which may lead to the purchase of subpar instrumentation. It is important to always maintain quality and not “race to the bottom” to compete for clients. Similarly, under no circumstances should physicians recommend a procedure purely for personal gain. It is a physician’s duty, especially aesthetic physicians, to take their patients and their safety seriously.
Quality documentation should be used, especially in spa-like environments which are very lax. Medical sheets and meeting summaries should be implemented to evaluate the patient and any needs or concerns he or she may have. Legal consent forms should also be incorporated and should be honest, informative, and protective for both the patient and the physician.
It is important to remember that aesthetics is not just a business but a medical profession. Physicians should choose patients who are “in need” versus those who “can pay”. Additional consideration should be paid to a patients’ age and why he or she wants a procedure done:
There are 11 points of patient rights that all physicians must abide by as well as the ethical code (Table).
When presenting aesthetic work, physicians have a duty to patients, colleagues, and non-medical personnel. Some dermatologist have a tendency to present their best results in their best condition and hide non written tips of experience from colleagues.
Present disclosure: The presenter did not have anything to disclose.
Written by: Debbie Anderson, PhD
Reviewed by: Victor Desmond Mandel, MD