An adult who may refuse treatment may also choose a procedure others think unnecessary

The argument

The primary objection to criminalising cosmetic surgery is that it would override the authority a person has over their own body. Opponents point out that the same legal and ethical tradition which allows a competent adult to refuse life-saving treatment, to donate a kidney to a stranger, to take up dangerous work and dangerous sport, and to mark their skin permanently, treats the person as the one entitled to decide what risks are worth running on their own account. Criminalising a procedure because others judge the reason insufficient reverses that, and opponents argue it cannot be done for appearance alone without abandoning the principle everywhere. Opponents stress that the judgment of necessity is being made by the wrong party. What an alteration is worth depends on what it is like to live in the body in question, and that is knowledge the person has and the legislator does not. Someone whose appearance is a source of continuous distress, or who has been injured, or whose features have changed through illness or age, is weighing something that does not appear in the category of the merely cosmetic. An outsider who calls the procedure unnecessary is, on this view, describing their own indifference rather than the patient's situation. Opponents also argue that criminalisation singles out a category by taste rather than by harm. The risks involved are comparable to, and often lower than, risks the law permits people to take for recreation, and lower than risks it permits them to take for money. If the concern is harm, opponents argue, the measures that address it are licensing, qualification requirements, disclosure, advertising restrictions and enforcement against bad practitioners. Each keeps the decision with the person while raising the standard of care they receive, which is what the law does in every other field where adults choose to accept risk.

Premises

Counter-arguments

Proponents of criminalisation reply that bodily autonomy has never been absolute, and that the law already refuses to let consent justify a range of harms, requires helmets and seatbelts, and restricts what people may sell including their organs. They argue that the comparison with dangerous sport misses the point, because there no third party is required to inflict the injury, whereas here a doctor must perform it, and medicine has obligations that are not satisfied by the patient's agreement. They also argue that treating the patient's own valuation as decisive ignores how that valuation was produced, and that a choice shaped by an industry which profits from dissatisfaction is not the free exercise of autonomy the argument describes.

Rejecting the premises

[Rejecting P1] Each of those permissions is hedged, and the law also forbids consent to many harms and restricts what people may sell, including their organs. [Rejecting P2] A valuation produced by an industry that profits from dissatisfaction is not the independent personal knowledge this premise assumes. [Rejecting P3] In dangerous sport no third party is required to inflict the injury, whereas here a doctor must perform it and is bound by obligations consent does not discharge. [Rejecting C] Licensing and standards regulate how the procedure is done without addressing whether it should be done at all.