I agree whole-heartedly.

I agree with this.

Would it not be offensively parental and authoritarian for a plastic surgeon to refuse the patient's request for no good reason other than to quote some obscure opinions of a select few? How offensive would it be for the surgeon to imperiously tell the patient that s/he (the surgeon) and some other select few people who conducted an obscure "study" actually know much better than the adult patient what is best for him/her when it comes to an elective, cosmetic procedure?

While the surgeon should definitely inform the patient of the risks of any requested procedure and also ascertain whether the patient is of sound mind and capable of informed consent, if the patient is mature enough and is of sound enough mind to understand the risks, yet still desires to undergo the procedure, then, for the most part, the patient should be allowed to make his or her own choice.

My only caveat to fully honoring patient choice is that I do believe that surgeons should also retain their right to refuse to perform requested procedures when s/he determines that the risks of any procedure far outweigh any possible benefit to the patient (as when the risk of death is statistically too high just for an elective, non-lifesaving procedure) or, again, when the surgeon believes the patient to be mentally ill or mentally challenged (such as when a patient exhibits signs of Body Dysmorphic Disorder . . . and, no, not all patients seeking plastic surgery have this disorder . . . or if the patient is showing signs of dementia). Under any of these conditions, only then would it become unethical for the surgeon to proceed with the requested services.

While there are risks to any surgical procedure, statistically speaking, a surgeon cannot truthfully tell a healthy 20-year-old woman that the risks to her undergoing breast augmentation are simply too high for the procedure to be done. The potential risks should be clearly explained though, and she should then be allowed to decide for herself whether or not she wants to proceed. On the other hand, for example, if a patient has a medical condition which makes undergoing surgery disproportionately life-threatening, then the surgeon is making a responsible decision to refuse to perform an elective surgery because s/he does not want to place the patient at undue high risk.

But, in general, any adult of sound mind (i.e., one who is not mentally ill nor mentally-challenged) should not be disallowed to make his or her own choices (in this case, choosing to undergo elective surgery), so long as the choices do not harm any other person. I find it offensive for anyone to dictate to others what is or is not "acceptable" to do with their own bodies and to seek to limit for others the choices available to them.

If we do not personally like an option, we should always be free to choose not to select it. But we shouldn't seek to prevent others from choosing it. I don't think adults should be "protected" from making their own decisions, no matter how horrible a third party may think their decision to be. It would be an abuse of a person's liberty to try to protect them from making what you would personally deem a "bad choice." Just think of all the choices you would be limited in making in your own life if you had to have every choice "approved" by the majority -- because in every area of life, there is always another competent, sound-of-mind adult who thinks you are making the worst choice imaginable.

So, no, I do not see how it could be alleged that a plastic surgeon is doing anything unethical by performing a requested elective procedure on a healthy, competent, informed, and consenting adult whose risk for adverse complications is considered to be statistically low.

Its the patients choice.

I agree with you.