Table 1.
Beauchamp and Childress’ Ethical Principles52 in the Context of Aesthetic Medicine
| Respect for Autonomy | |
|---|---|
| Definition | Patients have the right to privacy and decision-making in their care |
| Aesthetic applications | Informed consent and shared decision-making ensure patient values and privacy are respected |
| Example ethical challenge | Limited patient recall of risk and complications55,56; sharing patient images on social media platforms |
| Strategies | Comprehensive informed consent discussions,54 the “SHARE” Approach for shared decision-making,57 obtaining consent for the use of patient images on social media44 |
| Beneficence | |
| Definition | Moral obligation to provide treatments that benefit the patient |
| Aesthetic applications | Noninvasive treatments can improve patient concerns64–66 and offer psychological benfits67–69 |
| Example ethical challenge | Defining aesthetic “benefits” is challenging given the subjective nature of aesthetic outcomes and evolving beauty standards10 |
| Strategies | Use of validated patient-reported outcome measures like the FACE-Q Aesthetic module for aesthetic procedures13,70 |
| Nonmaleficence | |
| Definition | Treatments must not cause harm to the patient |
| Aesthetic applications | Practitioners must ensure that treatments are in the patient’s the best interest and avoid aesthetic procedures that are unnecessary or associated with excessive risk59 |
| Example ethical challenge | Excessive use of dermal fillers can lead to unnatural “overfilled” outcomes, distorting the patient’s and the public’s perceptions of “normal” or ideal35 |
| Strategies | Use of shared decision-making to understand patient goals,57 declining procedures that do not align with ethical practices or the patient’s best interests60 |
| Distributive justice | |
| Definition | Access to care should be equitable regardless of clinical or demographic factors |
| Aesthetic applications | The elective nature of aesthetic procedures introduces financial barriers, creating a two-tiered system that favors patients from higher socioeconomic backgrounds. |
| Example ethical challenge | Prioritization of appointments for high-paying clients71; off-label use of drugs such as semaglutide for weight loss, leading to drug shortages and cost inflation for diabetic patients72 |
| Strategies | Physicians should consider the boarder societal implications of their clinical decisions, exercising careful selection treatments and implementing creative strategies, such as payment plans, to ensure the affordability of care |