A Question of Ethics: Should We Treat Patients Under 18?
As voices grow louder calling for a ban on Botox for young teenagers in Britain, we can hear the logic in their argument here in Canada. Yes, practitioners can legally treat patients under 18 years of age in Canada. But ethically, that’s a whole different issue.
Save Face, a U.K. registry of accredited practitioners which campaigns for strong regulations in Britain, has been leading efforts to ban under-18s from getting cosmetic treatments. And British lawmakers are now working to make the practice illegal.
“We must stop the dangerous and unnecessary non-medical procedures that can ruin children’s lives,” said Conservative parliamentarian Laura Trott, who is spearheading a bill to criminalize the provision of Botox and fillers to under-18s. “This cannot be allowed to continue.”
It’s hard to argue against that. In Canada, too.
We know that Botox and fillers are no longer used strictly as anti-aging treatments by older women.
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But in my professional practice, I draw the line at providing fillers or Botox to anyone under 18. Personally, I am just not comfortable treating anyone that young.
Health Canada approval of medical aesthetic products comes after neuromodulator companies present comprehensive studies related to the safety and efficiency of those products.
The clinical studies submitted by the manufacturers for government approval are on patients between the ages of 18 and 65. Therefore, any use of that approved product on someone under 18 would be considered off-label. Ethically, the studies have not proven that the products and procedures are safe for them.
Another problem stems from the influence of social media on under-18s who want treatments. They may be seeking an alteration to their looks for wrong reasons.
Social media filters can make girls look like they have had procedures. So, they want to look like their filtered images.
Decisions can also be influenced by celebrity endorsements for Botox. Even worse is if teenagers have been mocked or bullied on social media about their smile lines or thin lips or whatever might trigger that teen angst we are all familiar with.
Neither those things nor a perfect ‘selfie face’ are reason to get medical aesthetics treatments.
BBC Radio 4 Woman’s Hour – ‘No under 18 needs cosmetic Botox or dermal fillers
“This is so, so dangerous,” says Save Face director Ashton Collins. “Girls think these are risk-free treatments like getting your nails or hair done, when in fact they are serious medical treatments that could cause horrible things if they go wrong.”
Save Face received 45 complaints of botched procedures on under-18s in 2019, up from nine in 2018. The youngest girls were 15 and almost all had found their treatments via social media.
Regulations in Canada are far tighter than in Britain, where Collins said anyone could pick up a syringe, watch a YouTube video and set themselves up in business.
But we’re not perfect in Canada. Unfortunately, there are unlicensed and poorly trained operators here. And we don’t have official age regulations.
As always, it falls on us, the professional medical practitioners, to make sure our industry adheres to safety and ethics in all that we do.
What do you think about this issue? Please comment below.
Yes, in some case there are therapeutic reasons for seeking treatment. Or perhaps a young person has a deformity that needs to be addressed.
The scrupulous and ethical practitioner will do a thorough consultation on all patients and properly assess what’s the purpose of their treatment. Detailed consults will reveal if underlying emotional or psychological issues are forcing their decision.
Our treatments cannot make emotional or mental health issues go away, and patients of all ages should be urged to think carefully about why they wants things done.
As for children under 18, it’s fair to assume they simply aren’t mature enough to make those non-emotional decisions.
That reality, and the questionable ethics, are good reasons why a practitioner should think twice before treating anyone under the age of 18.