The headline of a recent article on the Canadian Broadcasting Corporation’s website reads: “Labiaplasty defended by plastic surgeons.” The article discusses this often futile and possibly harmful genital surgery. There has been a rise in women requesting the procedure and most often the requests are based on the aesthetic concerns that the women have. As the article discusses, this is yet another example of unrealistic expectations and the wish to conform to some form of beauty that is questionable and unattainable. It is certainly of concern that the desire for beauty is now invading all the nook and crannies of women’s bodies and the increase in women asking for the procedure is even more worrisome. It is not as if the women seeking such a procedure are in a higher risk group more prone to suggestion. Although relatively small, a study examining this issue has concluded that the women seeking labiaplasty do not differ from those who have no desire for the procedure. This is a problem that is not going away.

What caught my attention is that the article also mentions that doctors are divided on the issue of labiaplasty. Actually, it is not that doctors are divided in general but more accurately that many plastic surgeons are in favor of performing this procedure while many OBGYN physicians are not if the reasons are purely aesthetic. It is of no surprise that plastic surgeons talk about the patient’s right to demand a procedure that would make her feel better; it is a patient’s right to choose. However, according to the article, OBGYNs are more concerned about the long-term consequences of this surgery and they perceive the need to educate women on the procedure.

More than viagra online sales 700,000 gallbladder surgeries have performed annually in the U.S. Tadaga Strong is good to take in buy generic levitra some dosages of antibiotics. That’s because you are going to need to request all three of your reports from the credit bureaus. cheap order viagra A healthy diet and regular exercise may tadalafil for women donssite.com greatly improve impotence by reducing the risk factors. Here we have an area of medical practice overlap: plastic surgeons are competent and can perform this procedure with little risk and the same goes for OBGYNs. However, the manner in which the latter approach the issue is radically different. If the principle of nonmaleficence is invoked by plastic surgeons, it is in the context of the type of surgery that is best to achieve the desired results. Patient satisfaction after the operation is a primary concern. OBGYNs are concerned about the long-term effects. For these doctors, the principle of nonmaleficence is invoked in the context of a useless procedure and the possible harms that may come from it in the decades following.

What is to be done here? Should the two groups remain at odds and simply let the patient decide for herself who she wishes to consult? After all, patient autonomy must be respected. However, it does matter how the patient goes about finding out the information she needs and whether she has access to the right type of information. In order to provide the best access to complete information, it should be the duty of plastic surgeons to require a consult with an OBGYN physician. I can hear the protest of plastic surgeons; after all they are specialized physicians and they know what they are doing. This is not the first time that specialization causes concerns: specialization create niches but patient care is not always well served by a very narrowly constructed medical practice. I am not advocating that we get rid of specialists. For example, we need physicians who specialize in neurosurgery. However, neurosurgeons work well with other specialists, nurses and health care professionals. We see a prime example of networking in the case of palliative care. Thus, it is not as if specialized medical professionals cannot talk to other care professionals. The matter in more complicated in this case, however.  There are competing interests: the desire to make money and the perceived right of patients to demand a particular procedure as well as the long-term well-being of the patient. Nevertheless, in order to respect patient autonomy and make sure that the patient is educated in the short and long-term consequences of her decision and adhere more fully to the principle of nonmaleficence, a consultation with an OBGYN should be required. It can be countered that this will unduly increase health care costs for a procedure that is quite safe. However, I think we are at a cross-road of sorts: medicine is complex and patient care is multifaceted. Plastic surgeons must critically examine the discourse they use surrounding patient autonomy and nonmaleficence. These are not principles devoid of context; all medical interventions have consequences. We hope they are good consequences but they often have a negative side. It is crucial to know what the long-term effects of a procedure might be. A physician should have enough care and respect for her patient and take the long-term well-being of that patient into consideration; if this requires talking to another specialist, then a consultation should be arranged.