The medical world has also succumbed to the pressure to consume more. The clients decide which treatment they want to undergo; they choose how long they take addictive medication and follow the doctors. As a result, they sin more and more against the medical code.

The Michael Jackson Syndrome

In today’s society the individual is central. The customer is king! He can get what he asks for with the right price tag. Few or no limits are placed on the consumer and individual-oriented urge for more. Everything is purchasable! Humanity cannot go much further than space tourism.The medical world, despite their code of conduct, is also succumbing to this tendency. The King of pop, Michael Jackson, is the victim of not adhering to this code. He was dissatisfied with his appearance, so he had a lot of cosmetic surgery performed: his nose, his chin, his eyebrows, a complete facelift. When Toby Mayer, an American surgeon, refused further treatment, Michael Jackson found another surgeon without any problem.The musical genius died far too early due to addiction to plastic surgery and painkillers. No family or doctor in his entourage informed him of the possible risks of frequent interventions and excessive use of pain-relieving medication.

The theory of the Belgian medical code

“The doctrine of medical duties is the set of principles, rules of conduct and customs that every physician must respect or use as a guideline in the practice of his profession.” (article 1)The code of medical ethics was drawn up by the national council of the order of physicians and offers practicing physicians good guidance to set clear boundaries in the constantly changing society.The physician must at all times monitor the health of the individual and the community. In medicine, the humane mission is central. (Article 3) Isn’t Article 10 often violated, which states that medicine may not be regarded as a commercial business in any way?The customer is king does not apply in all sectors and certainly not in the medical world where the customer calls on the expertise of a physician with the aim of promoting health. A doctor is free not to perform a certain treatment for personal or professional reasons, except in cases of urgency or out of his humanitarian duty (Article 28).Article 36 states that the physician has diagnostic and therapeutic freedom. This means the following:

• he avoids unnecessarily expensive examinations or treatments.
• he only prescribes medication or treatment if this is medically justified and not because the ‘customer’ asks for it.
• it prevents overconsumption and overdose of medication.

The doctor tries to prevent any form of dependence. The patient is informed of the risks of misuse and abuse of addictive substances (Article 37 a).“The physician is committed to helping patients who are dependent on or abuse such substances. He opts for a multifactorial approach to the problem on a physical, psychological and social level.” (Article 37 b)If substitutes are provided, it will be regularly checked whether they can be reduced or discontinued. (Article 37 c)Article 49 states that a surgeon may refuse an intervention if the indication is insufficiently justified or if he has another valid reason.A physician has a social and economic responsibility. Whatever social environment he works in, he must improve the quality of care. (Article 100)

The derailed practice

The doctrine of duties is diametrically opposed to the daily practice of cosmetic surgery, gastric bypass operations and changing GPs in search of a medication prescription. An addiction is often kept alive. In addition, most citizens who pass the age of 45 are made dependent on one drug or another. This is mainly done for commercial reasons rather than for medical reasons.An article in De Morgen cites a study conducted in sixteen countries. It shows that seventeen percent of girls and twelve percent of boys between the ages of fifteen and twenty-five are considering plastic surgery. In Belgium there is a disagreement among surgeons as to whether this is responsible for young people under the age of eighteen. Fortunately, the parents also have to agree to an intervention. The girl in the article had to pay the 3800 herself. In return, she still has no feeling in her breasts, has sleep problems and is more likely to develop breast cancer.The procedure is often labeled ‘medically necessary’, causing the health insurance company to reimburse a large part of the costs.Before proceeding with cosmetic surgery, a behavioral approach should be considered. The young people are not yet fully developed mentally and physically . During puberty, low self-esteem or questioning oneself is inherent to the stage of life. The young people reflect on their environment. Instead of being obsessive about their appearance, they can be better supported in accepting their own person. Every person is unique. As soon as a person approaches themselves in a positive way, they will be much more self-confident in life.In practice it is not always obvious. It is a balancing act for physicians between the code of good practice and the demanding, sometimes mentally unstable patient.