SELF AS CREATION AND ARTWORK

Gloria Gaynor's hit song taken from the 1985 film, 'La Cage aux Folles' opens with the line, 'I am what I am: I am my own special creation.' Previously associated with gay culture, the song could now be as a prophetic anthem for the 21st century.

In the future, we will each be our own creation, our own artistic masterpiece. The explosion of interest in distance learning — to which I have personally been a witness as Director of the leading distance learning school for Western philosophy — shows that this interest in self-enhancement is not confined to mere bodily appearance.

Plastic and cosmetic surgery are no longer the resort of accident victims or those less favoured in their natural endowments. They are the front-line resources for anyone who wants to re-make and re-invent themselves.

The down side is that this requires trusting oneself to the surgeon's skill and expertise. Not all equally skillful. And some are less ethical than the Hippocratic oath requires.

Recently, the unusual case of apotemnophilia has been highlighted, which tests medical ethics to their limit: physically healthy patients who present with the sincere and urgent desire to have a limb amputated because it 'feels wrong' to have two arms, or two legs.

If a patient asks a plastic surgeon to perform an operation involving mutilation of the face or a part of the body, how far is it acceptable to go? Is the doctor obliged to consider what that person might or might not desire in the future, when performing an operation which cannot be reversed?

These are difficult questions to which no-one has yet put forward convincing answers.

© Geoffrey Klempner 2008