Some question whether plastic surgeons bear responsibility for promoting suspect norms of beauty, given that certain types of cosmetic enhancements reinforce common conceptions of normality that are harmful to society.
Advance directives, substituted judgment, and the best-interest standard all have limitations that constrain their usefulness in making medical decisions for patients who cannot choose for themselves.
Advance directives do not always resolve questions about the best care for patients who no longer have decision-making capacity; physicians and patient surrogates can take alternative approaches to arrive at the best care decision.