Bioethics of appearance and the quality of life issue: who makes the decision? Academy of Otolaryngology-Head and Neck Surgery

摘要

The article by Sulmasy1 presents interesting and important observations on ethical issues concerning otolaryngology and head and neck surgery. Moreover, it very intrigu-ingly deals with one of the eternal questions of philosophy, namely, the relationship between ethics and esthetics. Sulmasy enters this traditional debate by revisiting Plato's philosophical system consisting of 3 basic values (forms): beauty, truth, and goodness.1 Sulmasy structures his observations around a particular case of a patient who, at his own insistence, had undergone a total glossectomy and laryngectomy for squamous cell cancer. His social supports were weak. He was homeless, unemployed, and had just recently moved to New York after living much of his adult life in a California hippie commune abusing drugs, alcohol, and tobacco. He stated that his diagnosis led him to religion and a life without addiction. He did remarkably well with surgery, and his recovery was quick. Although rendered unable to eat or speak, with a large scar, and with a high likelihood of dying from his underlying disease, he seemed optimistic and happy. Sulmasy ends this case report with the question, "Where is the beauty, truth, and goodness in such a situation?" He then takes into consideration Plato's argument that goodness and truth are deeper than the mere appearance of beauty.