In this series of posts we are examining the ethics behind medicine. This includes the entire ethical spectrum of behavior by doctors, patients, nurses, and the entire medical system. Here we present another case scenario about a patient.

A 36 year old man presents to his plastic surgeon for cosmetic deformity. He would like a rhinoplasty for his nose. This is something that he has always wanted done. His plastic surgeon asks him why he wants the surgery as he is a good looking guy who is fit with good self esteem. His surgeon asks him if he has ever had plastic surgery before. The patient says no. Thus the surgery is scheduled and both the doctor and patient agree to proceed.

During the surgery the surgeon finds significant scar tissue that clearly indicates a prior surgery. This circumstance significantly lengthens the surgery and complicates the surgery. Nevertheless due to the surgeon’s skill the surgery is successful.

Clearly this is a type of unethical behavior by the patient. One that could significantly increase the risks of the surgery for both the patient and the doctor.

Is this unethical? What if the doctor has a policy of not doing revision plastic surgery and this is the only way for the patient to get the surgeon to agree to do the surgery?

Maybe some of you are thinking that this is not a big deal. What about if the patient fails to disclose that he has HIV or Hepatitis C and the surgeon has a blood exposure or needle stick in the case?

I won’t go this far but some could argue that failure to disclose could be criminal if there were harmful outcomes because of that failure to disclose.

I would be interested to hear what readers think.