Shaped to Fit?: Shaped to Fit?: Teenagers, autonomy Teenagers, autonomy and cosmetic surgery.and cosmetic surgery.

Melanie Latham Melanie Latham Reader in Law, Manchester Metropolitan University,Reader in Law, Manchester Metropolitan University,

Changing Up a Gear Conference, Manchester,Changing Up a Gear Conference, Manchester, 11 11thth September 2008. September 2008.

StatisticsStatistics

Members of the British Association of Members of the British Association of Aesthetic Plastic Surgeons carried out Aesthetic Plastic Surgeons carried out 10,738 procedures in 2002 and 10,738 procedures in 2002 and 22,041 in 2005.22,041 in 2005.

Researchers Mintel estimated that Researchers Mintel estimated that 100,000 Botox injections carried out 100,000 Botox injections carried out in 2004 in UK alone. in 2004 in UK alone.

Mintel estimate cosmetic medicine Mintel estimate cosmetic medicine market worth £539m 2006 (£1bn market worth £539m 2006 (£1bn 2009). 2009).

TeenagersTeenagers

NumbersNumbersProceduresProceduresComparative dataComparative data

High level of riskHigh level of risk

Risks include: general anaesthetic risks Risks include: general anaesthetic risks death, heavy blood loss, bruising and a death, heavy blood loss, bruising and a high risk of infection. high risk of infection.

Silicone-induced cancers, autoimmune Silicone-induced cancers, autoimmune disorders, depression and suicide.disorders, depression and suicide.

Dr. Gustaf Aniansson caused septicaemia, Dr. Gustaf Aniansson caused septicaemia, kidney failure, heart attack.kidney failure, heart attack.

Dr. David Herbert called a psychopath.Dr. David Herbert called a psychopath. Dr. Steven James Walker nicknamed ‘Dr. Dr. Steven James Walker nicknamed ‘Dr.

Death’.Death’.

Low level of regulationLow level of regulation

Unfair Contract Terms Act 1977Unfair Contract Terms Act 1977Supply of Goods and Services Act 1982Supply of Goods and Services Act 1982Consumer Protection Act 1987Consumer Protection Act 1987Medical Devices (Amendment) Medical Devices (Amendment)

Regulation 2003Regulation 2003Care Standards Act 2000Care Standards Act 2000Health and Social Care (Community Health and Social Care (Community

Health and Standards) Act 2003Health and Standards) Act 2003

Care Standards Act 2000Care Standards Act 2000

National Care Standards CommissionNational Care Standards Commission National minimum standardsNational minimum standards Annual inspectionAnnual inspection Appropriately qualified practitionersAppropriately qualified practitioners Informed consent and counsellingInformed consent and counselling Formal complaints procedureFormal complaints procedureHSC (CHS) Act 2003HSC (CHS) Act 2003Commission for Healthcare Audit and InspectionCommission for Healthcare Audit and Inspection(aka the Healthcare Commission) from April 2004 (aka the Healthcare Commission) from April 2004 Expert Group on Regulation of Cosmetic Surgery : Expert Group on Regulation of Cosmetic Surgery :

Report to Chief Medical OfficerReport to Chief Medical Officer (January 2005) (January 2005)

Risks associated with Risks associated with self-regulationself-regulation

General Medical Council (GMC)General Medical Council (GMC)British Association of Plastic, British Association of Plastic,

Reconstructive and Aesthetic Reconstructive and Aesthetic Surgeons (BAPRAS)Surgeons (BAPRAS)

British Association of Aesthetic British Association of Aesthetic Plastic Surgeons (BAAPS)Plastic Surgeons (BAAPS)

British Association of Cosmetic British Association of Cosmetic Surgeons (BACS)Surgeons (BACS)

Cosmetic Surgery CasesCosmetic Surgery Cases

Christine Williamson v East Christine Williamson v East London and the City Health London and the City Health Authority Authority

Norton v GMCNorton v GMCO’Keefe v Harvey-KembleO’Keefe v Harvey-Kemble

Teenagers and the LawTeenagers and the Law

Gillick v West Norfolk and Wisbeck AHA.Gillick v West Norfolk and Wisbeck AHA. Consent of teenager over 16 equivalent to Consent of teenager over 16 equivalent to

adult. (Family Law Reform Act 1969, s.8)adult. (Family Law Reform Act 1969, s.8) Can a teenager under 16 consent to Can a teenager under 16 consent to

cosmetic surgery? If surgeon considers her cosmetic surgery? If surgeon considers her mature enough to understand what mature enough to understand what cosmetic surgery entails physically and cosmetic surgery entails physically and emotionally? emotionally?

Gillick competent minor has right to Gillick competent minor has right to confidentiality, but surgeon may face civil confidentiality, but surgeon may face civil suit for battery or prosecution for criminal suit for battery or prosecution for criminal assault without parental consent, in cases assault without parental consent, in cases of extremely invasive and risky surgery.of extremely invasive and risky surgery.

Beauty and autonomyBeauty and autonomy

““For virtually all women, as women, For virtually all women, as women, success is defined in terms of success is defined in terms of interlocking patterns of compulsion: interlocking patterns of compulsion: compulsory attractiveness, compulsory attractiveness, compulsory motherhood, and compulsory motherhood, and compulsory heterosexuality, patterns compulsory heterosexuality, patterns that determine that determine the legitimate aims of the legitimate aims of attractionattraction and motherhood.” (K.P. and motherhood.” (K.P. Morgan, 1991)Morgan, 1991)

Self-determination and Self-determination and autonomyautonomy

““I can treat women’s ongoing struggles I can treat women’s ongoing struggles to justify a contradictory practice like to justify a contradictory practice like cosmetic surgery as a resource for cosmetic surgery as a resource for developing a feminist response which developing a feminist response which speaks to women’s experiences speaks to women’s experiences rather than simply reiterating the rather than simply reiterating the correct line on women’s involvement correct line on women’s involvement in the beauty system.” (Kathy Davis, in the beauty system.” (Kathy Davis, 1995)1995)

ConclusionsConclusions

Patients who choose cosmetic surgery Patients who choose cosmetic surgery may be fully aware of their reasons may be fully aware of their reasons and the risks involved. They may and the risks involved. They may only be choosing to utilise the only be choosing to utilise the rewards on offer after transforming rewards on offer after transforming themselves. themselves.

Can women be empowered through Can women be empowered through body modification?body modification?

How far does this apply to teenagers?How far does this apply to teenagers?