Ethics Reflection Paper

Andrew Miron
Julie Ross
10/13/14
An ethical dilemma that presents itself to people who are involved in the world of
cognitive impairment is the idea of performing cosmetic surgery on one who has physical
differences because of the cognitive impairment that they have.
My first instinct, from a personal/teacher perspective is that it isn’t a good idea. My initial
thoughts are that it would be unethical to promote a surgery to a young person, that comes with
inherent risks, when it can be avoided. Any type of surgery on someone, especially when they are
young, presents may risks that can hurt someone. In addition to this, I feel that as a parent to a
child with a cognitive impairment, making them have some sort of cosmetic surgery to make
them look more “normal” sends your child a message that you don’t accept them as they really
are. I feel that the child may have complex thinking that their parents would love them only if
they were “normal”, perhaps like their siblings. I am not a parent but I am training and
learning/enhancing my perspective as a teacher. I feel that no matter what my student looks like
outwardly, I wouldn’t treat them any differently and they would receive the same opportunity as
any other person. I feel that they surgeries at a young age would tell a child that they are only
going to be accepted if they look a certain way instead of being comfortable and confident in
who they are. Students with cognitive impairments have the same feelings and emotions that any
other student would have and can be hurt and scarred from the experience. The only times that I

feel it would be ethically okay to do cosmetic surgery on a child with cognitive impairment
would be a tongue reduction surgery for a child with down syndrome.
Surgery is always something that comes with a risk, however if the reward outweighs the
risk, for example, the surgery will improve the overall quality of life of the child, then I would
ethically understand taking that risk. An example, from a parental perspective that I feel would
warrant cosmetic surgery would be if I was a parent of a child with Down syndrome. One of the
common characteristics of someone born with Down syndrome is the protruding of the child’s
tongue. This happens for a few reasons. Someone with Down syndrome is born with a smaller
mouth that usual and have lack of muscle tone. A surgery that is done sometimes on children
with Down syndrome is called a partial glossectomy where a wedge of the tongue is removed so
they can have a chance at improved speech intelligibility. In addition a partial glossectomy
would cause the child to be able to keep their tongue inside their mouth and as a result they will
be able to reduce their mouth breathing and involuntary drooling. I understand, from a parent
perspective, why they would ethically want to have the surgery done. Like I said earlier, if they
reward outweighs the risk and the goal is an increased quality of life, I can ethically say that I
understand why the procedure would be done.
This will always be something that will be an ethical dilemma for people. I think, at the
end of the day, if the goal is to increase the quality of life the procedure is an ethical one.
However, for purely cosmetic and “fitting in” reasons, I feel that would cause a child to feel that
they are not accepted and have issues with dealing with their impairment.