Is plastic (cosmetic) surgery permitted by the Torah? Is there a difference in the Jewish view between reparative and elective surgeries? Does Judaism approve of cosmetic procedures (not life saving, and not physically reconstructive) if it makes the person feel better?
The discussion over this question goes all the way back to the ancient Rabbis. Granted that we are forbidden to injure other people, are we permitted to cause physical damage (chavalah) to ourselves? If so, for what reasons? (M. Bava Kama 8:5, B. Bava Kama 91a-b). The decision, as worked out in the traditional halakhic sources, is that we are forbidden to do so only if the act is performed in an attitude of contempt for the body and when undertaken for harmful or pointless ends. Cosmetic surgery falls squarely in the middle of this debate. Is it “contemptible”? If not, is it “harmful” or “pointless”? As you can imagine, Jewish scholars are divided over this issue, and the answer that any one of them would give you probably has a lot to do with the reason(s) for which a particular procedure is undertaken. Generally speaking – and there will be exceptions to this general rule – most will have little problem with reconstructive surgery, since that can be justified as part of our response to disease. Cosmetic surgery that is elected for the purpose of physical enhancement, however, is a much more difficult issue. To the extent that the surgery can be justified on serious psychological or emotional grounds (however that term is to be defined), we can say that Jewish tradition is more likely to approve of it. The response will be much more hesitant, however, if the procedure is to be undertaken simply because “it makes the person feel better.” In that case, Jewish teaching would likely want us to think carefully about why we are dissatisfied with our body image and why we are willing to undergo what may be very expensive and involved surgeries in order to “enhance” ourselves. It would have us consider, in other words, how we define the idea of physical beauty and ask ourselves very carefully whether we truly honor our bodies – and their Creator – when we seek to “improve” upon them in this fashion.
Four teshuvot (legal responsa) have been written by Orthodox rabbis on the subject of cosmetic surgery and Halacha (Jewish law). They each present different approaches to the topic, but I will cover those first and then give my opinion from a Jewish values context.
Rabbi Chaim Jachter explains the teshuvot of several rabbis including Rabbi Moshe Feinstein, a Halachic authority in the Orthodox movement, who permitted a young woman experiencing difficulty finding a husband to undergo cosmetic surgery to improve her appearance. Feinstein permitted the surgery based on Maimonides' understanding of the prohibition of chavala (wounding in a degrading manner). In general, the Torah prohibits wounding another person (Deuteronomy 25:3), and the Talmud (Bava Kama 91a) states that this prohibition applies even to wounding oneself. Maimonides writes that this prohibition applies when it is performed “in a degrading manner.” Maimonides rules that an individual is forbidden to wound himself, but that if the wounding is done in a beneficial manner the prohibition of chavala -- to others or oneself -- does not apply. An individual may wound himself if it is done for his benefit.
Rav Waldenberg, a medical ethicist, categorically forbids all cosmetic surgeries, believing that the doctor's license to heal applies only to curing an illness and not to altering one’s appearance.
Rav Yitzchak Weisz focuses his teshuva on two issues: chavala and sakana (a dangerous situation). First, he explains that cosmetic surgery is not forbidden unless it is done in a degrading manner. However, Weisz believes that the danger involved in any surgery is of major concern. In an earlier responsum, he forbids undergoing any surgery unless it is necessary to save the patient’s life. Accordingly, he rules that one may not undergo surgery to remedy a problem that is not life-threatening.
Some rabbis, like Rabbi J. David Bleich, conclude that it cosmetic surgery is permissible in the case of great need (i.e., life-saving). There is also the category of the choleh, one who is considered to be sick. This category is broad enough, in my opinion, to include individuals who are suffering psychologically because of their outward appearance. If an individual is so emotionally distraught because of their appearance then I would consider this person to be a choleh (sick from depression). they should consult a physician (i.e., psychologist) for therapy and if it is determined that cosmetic surgery would make them feel better about themselves, then I believe that should be the value.
There are, of course, individuals in our society who become addicted to changing their physical appearance through cosmetic surgery (e.g., Joan Rivers, Heidi Montag, Michael Jackson, etc.) and that should be cautioned against. But if a person requires cosmetic surgery to improve their inner sickness, then I believe that is a Jewish value we should recognize.
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