Do smart kids deserve cheaper plastic surgery?


Incentives for students are everywhere— awards for students with the best GPA, presents from parents for each A their kid earns, school districts paying children to take AP tests, and giving plastic surgery as a reward to those who do the best on exams. Wait, what? We have to wonder when these incentives begin to cross the line and maybe violate what we think is right or wrong. If thinkers such as Duke’s own Prof. Ruth Grant have raised issues with the first three examples, the last situation certainly seems to raise some ethical questions.

Hospitals in South Korea have tapped into the obsession of rewarding students for their achievements, and they are now offering a very unique gift: discounted eye and nose operations for students who score well on university entrance exams.

A recent Reuters MSNBC article details the phenomenon and includes anecdotes about a hospital that gives rewards to mothers of students as well by giving them free Botox injections if their child performs well and chooses to get the plastic surgeries.

So are the hospitals doing something that is inherently wrong? Maybe not. After all, the students already want the surgeries and they are not being encouraged to do anything bad. In fact, they are being told to work hard and shouldn’t there be some payoff for getting good grades, especially when the competition is as tough as it is in South Korea?

Yet, at the same time, the hospital is essentially condoning the surgeries and telling children that being able to get your eyelids lifted and nose tilted is a privilege and ultimate reward for those who dedicate themselves to their studies. Because an established institution like a hospital is providing these surgeries as a reward, some may argue that the incentive is being reinforced and thus so are adolescents’ desires to change their physical appearance. This raises questions about whether high school students should be free to make their own decisions about their body or if they are too young to know better. As Grant has noted, incentives are usually offered by people in authority—an inherently unbalanced situation.  I would argue that a teenager on his or her way to college should be able to make a choice about plastic surgery, but I am quite fearful of structures that could consciously, or unconsciously, lead people to think that the surgeries are something they should or must get. At some point, people stop thinking for themselves and the surgeries turn into a societal beauty norm (and the hospital presumably makes a lot of profit along the way).

I am alarmed by how obsessed Korean teenagers seem to be with altering their appearance—there is a long reservation list of students hoping to get the operations if their tests go well. Yet, this is not all that different from the image conscious world in which Duke students find themselves on campus. It is not uncommon for people to go to great lengths (skipping meals, taking Aderol, not sleeping) in order to succeed in a highly competitive environment and look the part while doing so. It seems that there is a growing emphasis on fitting into the beauty standards of your social environment, and there may be structural choices (incentives from the hospitals) that are further perpetuating this.

Ultimately the question is: do we really want children to be studying harder in order to change how they look when they should be striving to do well so they can benefit from the value of having an education?

Additional issues:

Also, if you are interested in reading about something closer to home, this 2005 article from Duke’s student newspaper discusses one student’s battle with an eating disorder as well as the larger issues that exist on campus with body image awareness: http://dukechronicle.com/article/groups-promote-body-image-awareness

As well as more recent thoughts on the toll that competitive culture takes on students here: http://dukechronicle.com/article/mentally-healthy-devils and in broader society: http://opinionator.blogs.nytimes.com/2010/11/26/the-power-of-failure