Beyond the physicians perspective

Sylvia Ramirez and Gunther Scherz consider the multifaceted impact of ethics in medical aesthetics

The field of aesthetic medicine continues to grow rapidly, offering transformative procedures that enhance appearance and confidence. However, with this growth comes significant ethical challenges that affect not just clinical practice but the entire aesthetic industry. Ethical considerations in this field are essential to ensuring patient safety, trust, and the long-term sustainability of clinics. This article explores the ethical landscape in aesthetic medicine from both clinical and organisational perspectives, offering a broader understanding of the implications for patient care and clinic operations.

NAVIGATING PATIENT AUTONOMY IN AESTHETIC MEDICINE

Patient autonomy is a fundamental ethical principle, yet in aesthetic medicine, it often intersects with unique challenges. Patients frequently seek procedures based on external pressures from social media and peer influences, rather than personal health needs. According to Paul Elgey,1 the growing accessibility of aesthetic procedures and social media’s influence often shape patients’ expectations and create unrealistic standards of beauty. This makes it essential for physicians to guide patients toward realistic and healthy goals, ensuring that clinical decisions prioritise the patient’s overall wellbeing rather than fulfilling short-term desires.

Elgey emphasises the importance of balancing patient autonomy with professional integrity. While patients have the right to make informed decisions, it is the physician’s responsibility to offer guidance and sometimes refuse procedures that may not serve the patient’s best interest. Shared decision-making, based on a clear understanding of risks and benefits, is essential in upholding ethical standards.2

MARKET-DRIVEN DISCIPLINE AND ITS ETHICAL IMPLICATIONS

Aesthetic medicine is heavily patient-driven, often shaped by market forces rather than purely medical ones. Many patients arrive with preconceived ideas about procedures they want, often influenced by social media or internet research. According to the article in Modern Aesthetics, this shift presents significant ethical challenges as patients may request treatments that are neither medically indicated nor beneficial.3 Physicians must navigate these demands while adhering to ethical principles, especially the doctrine of non-maleficence, or “do no harm.”

Research shows that patients who rely on online resources before consultations are more prone to having fixed expectations. For instance, 59-70% of patients use the internet to evaluate procedures and practitioners, which can lead to bias and unrealistic expectations.4 In such cases, ethical physicians must be prepared to say “no” to requests for unnecessary treatments. Maintaining professional integrity while managing market pressures ensures that patients receive the most appropriate care, even when this means declining certain procedures.

THE INFLUENCE OF SOCIAL MEDIA ON AESTHETIC MEDICINE

Social media platforms like Instagram and TikTok have played a massive role in shaping contemporary beauty standards, driving demand for aesthetic procedures. However, this rise in demand comes with ethical challenges. Social media often perpetuates unrealistic ideals of beauty, contributing to appearance anxiety and dissatisfaction, especially among younger individuals.5 The use of beauty filters and airbrushed images only intensifies the issue, creating a distorted view of what is achievable through aesthetic procedures. A key challenge for physicians is the ethical management of their own social media presence. As highlighted by Modern Aesthetics, marketing in aesthetic medicine must maintain ethical rigor to avoid sensationalising results or promoting procedures without clear evidence.3

Physicians have a responsibility to provide accurate, evidence-based content that educates patients rather than misleads them. This aligns with the principles of ‘beneficence’ — acting in the patient’s best interest — and transparency in marketing.

CONFLICTS OF INTEREST AND ETHICAL INTEGRITY

Conflicts of interest are prevalent in aesthetic medicine, as financial incentives may sometimes influence treatment decisions. Astudy by Lopez et al. found that studies declaring financial conflicts of interest were seven times more likely to present positive outcomes, highlighting the risks of bias in clinical practice.6 This risk is further exacerbated by the commercialisation of aesthetic medicine, where clinics may be incentivised to promote certain treatments, products, or devices based on profitability rather than patient need.

An article in Philosophy, Ethics, and Humanities in Medicine explores how aesthetic practitioners can mitigate these conflicts of interest by ensuring transparency with patients about financial relationships and the rationale behind their treatment recommendations.7 By maintaining transparency and offering alternative treatment options, physicians can strengthen trust with their patients and adhere to ethical standards, particularly the principle of justice, which calls for fairness in healthcare.

ORGANISATIONAL ETHICS: FOSTERING ETHICAL LEADERSHIP IN CLINICS

Ethical practice in aesthetic medicine transcends individual physician behaviour, extending to the establishment of robust, clinic-wide ethical frameworks. Clinics that embed ethics into their organisational culture reap benefits that go beyond compliance, including enhanced patient trust, reduced legal liabilities, and higher employee morale. Research by Franczukowska et al. demonstrates a clear correlation between ethical leadership in healthcare organisations and improved employee engagement, satisfaction, and patient outcomes.8 This underscores the critical role of leadership in shaping ethical practices and ensuring alignment with the clinic’s values and goals.

Healthcare organisations are complex entities that grapple with a breadth of ethical challenges extending beyond the clinician-patient relationship. These challenges span management and governance, the implications of organisational decisions on diverse stakeholders —including practitioners, staff, patients, regulatory bodies, and the industry —and the balancing of key organisational goals such as quality care, financial sustainability, staff-management, medical research, and public accountability. Addressing this broad scope requires a comprehensive ethical framework that integrates organisational decision-making with stakeholder considerations.

The balance between financial sustainability and ethical commitments is pivotal. Clinics must ensure profitability to sustain operations, support staffdevelopment, and invest in advanced technologies. Simultaneously, a missiondriven approach rooted in patient-centred care and integrity builds trust and long-term loyalty. Leaders who align economic goals with ethical practices reinforce a culture of accountability, distinguishing their clinics in competitive markets where patients prioritise safety, transparency, and quality. By embedding ethics into every aspect of the organisation — training, communication, and decision-making processes — clinics can achieve sustainable growth while honouring their mission to prioritise patient well-being and staffsatisfaction.

Finally, clinics that operate with a strong ethical foundation often differentiate themselves in a competitive market.

Patients today are more discerning, often choosing clinics that demonstrate a commitment to safety, transparency, and patient-centred care. By maintaining ethical standards at both the clinical and organisational levels, aesthetic practices can build lasting reputations and ensure sustainable growth.

CONCLUSION

Ethical challenges in aesthetic medicine are complex and multifaceted, affecting every aspect of clinical practice and clinic operations. By adhering to the core ethical principles of autonomy, beneficence, non-maleficence, and justice, practitioners and clinics can navigate these challenges successfully. As highlighted in the referenced works, maintaining ethical integrity in the face of market-driven pressures, social media influence, and conflicts of interest is essential for ensuring patient well-being and long-term clinic success. Ultimately, ethical practices not only protect patients but also enhance the reputation and sustainability of aesthetic clinics in an increasingly competitive industry.