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Cosmetic interventions are booming. Many say ethical conversations are lagging

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Cosmetic interventions are booming. Many say ethical conversations are lagging
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Cosmetic interventions are booming. Many say ethical conversations are lagging

2026-05-06 19:08 Last Updated At:19:30

LOS ANGELES (AP) — Shula Jassell is insecure about the size of her chin and has periodically considered getting filler to make it bigger.

But when the 25-year-old from Southern California gives serious thought to the idea of repeatedly having to get the cosmetic procedure — it only lasts about a year — she wonders if a surgical implant would be more practical, even though the prospect of surgery scares her.

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Dr. Michael Obeng, center, performs liposuction at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Dr. Michael Obeng, center, performs liposuction at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng makes body markings using a surgical marker to indicate areas to be treated before performing liposuction and tummy tuck procedures at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng makes body markings using a surgical marker to indicate areas to be treated before performing liposuction and tummy tuck procedures at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

A patient receives a Botox injection at a clinic in Arlington, Va., on June 5, 2009. (AP Photo/Jacquelyn Martin, File)

A patient receives a Botox injection at a clinic in Arlington, Va., on June 5, 2009. (AP Photo/Jacquelyn Martin, File)

Plastic surgeon Dr. Michael Obeng performs a belly bottom reconstruction plastic surgery after a tummy tuck at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng performs a belly bottom reconstruction plastic surgery after a tummy tuck at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

“I just try to remember self-love, you know? Beauty is in the eye of the beholder,” she says as she verbally processes her internal struggle and talks herself out of getting any work done for now.

Technological advancements over recent decades have made various forms of body modification increasingly accessible — and inescapable on many social media algorithms.

As injectables like Botox, cosmetic plastic surgeries and GLP-1 medications such as Ozempic become more pervasive, people — often but not exclusively women — are grappling with the philosophical and ethical implications of turning to these interventions in a ceaseless quest for beauty, youth and conformity.

“We need to have a wider conversation about how to think about this in a way where we’re not putting the burden squarely on women, while also not taking away their moral agency,” said Natalie Carnes, a feminist theologian at Duke Divinity School. “Beauty is something that’s good. And beauty is something that is good to pursue. Botox and Ozempic and face-lifts, they’re all ways of really narrowing the cultural ideals of beauty.”

There has been little in the way of official guidance or explicit prohibitions from major religions. But a growing chorus of theologians, philosophers and bioethicists are calling for more conversations surrounding these procedures and treatments.

In March, the Vatican released a document on Christian anthropology decrying the “cult of the body.” “Once modified, often with relentless frenzy, the body becomes a body-object in which the person-subject mirrors themselves, creating a relationship in which the person is no longer his or her body but ‘owns’ a body,” it said.

Demand for cosmetic surgery in the United States has increased in recent years across all age demographics and ethnic backgrounds, says Dr. C. Bob Basu, president of the American Society of Plastic Surgeons. “Forty years ago, perhaps people would think, ‘Cosmetic surgery is for the superrich or the celebrity elite. It’s not for regular folk.’ That’s not the case anymore.”

One of the biggest changes he’s seen is more young people opting for interventions.

“They’re being proactive and thinking about preventive measures, whether it be baby Botox at a younger age to prevent wrinkles from starting or maybe considering a deep plane face-and-neck-lift in the late 30s or early 40s, rather than waiting until you’re in your 60s,” he said.

But despite its increasing ubiquity, many bioethicists say plastic surgery is not prioritized in their training.

“If you’re getting into bioethics and you rotate to learn about medicine, you go to the ICU, you go to places where the palliative care is for dying people, you’re looking at transplants. Nobody rotates to plastic surgery,” said Arthur Caplan, founding head of the Division of Medical Ethics at New York University Grossman School of Medicine.

As a result, plastic surgeons often must set their own boundaries for what they will and won’t do, without much specialized ethical training.

Many religions condemn vanity and praise modesty, which can inform attitudes toward cosmetic work.

Dr. Jerry Chidester, a member of The Church of Jesus Christ of Latter-day Saints, said he sees a broad spectrum of stances on plastic surgery within the church. Although some stricter interpretations of the faith may discourage interventions, Chidester said that attitude contrasts with the broader cultural landscape of Salt Lake City, where he’s based. Several studies suggest the area has a high number of plastic surgeons and procedures performed per capita.

When patients wrestle with whether to have an operation, Chidester tells them to not worry about what others will think.

“I’m like, ‘Look, if you want to do this or not, it’s up to you,’” he said. “It’s literally your body. Who cares if they think you’re doing it for vanity or for function or whatever? It is none of their business.”

Dr. Sheila Nazarian, a Jewish board-certified plastic surgeon, incorporates her interpretations of parts of the Torah for guidance on thinking about when it is appropriate to modify one’s body.

“If it’s bringing distress, then it’s OK,” she said. “My patient population, they’re all pretty well adjusted, happy, successful, intelligent people. But they need help with one little thing that they’d just rather not think about anymore.”

Dr. Michael Obeng, a Christian, has seen a dramatic shift in acceptance of cosmetic procedures in the nearly 20 years he’s been practicing.

“Now people are not even hiding it. They show their plastic surgery as a badge of honor, like somebody wearing their expensive bag,” he said. “We are aging slower and of course we are working much longer than our moms and grandmothers worked. In the marketplace, we have to look presentable.”

Obeng, a board-certified surgeon in Beverly Hills, specializes in a wide range of procedures from tummy tucks and Brazilian butt lifts to rib removal surgeries. He says he rarely feels tension between his faith and his work. It wasn’t until he came to a “crossroads” in 2018, when he began thinking through his willingness to perform certain gender transition surgeries.

He sought the advice of several pastors and religious leaders about what to do. “Nobody could give me an answer,” he recalled.

He said his faith ultimately led him to limit his practice to some gender-related procedures like breast augmentation, stopping short of genital gender-affirming surgeries, which he sees as harder to reverse.

Ivory Kellogg, a 29-year-old actor in Los Angeles, has been grappling with the tension she feels as a woman while pondering cosmetic interventions.

“There’s this expectation that once you hit 35, you think about doing a mini face-lift. That's a lot of pressure,” she said. “At the same time, I do want women to feel like they’re allowed to do whatever they want. Like if you want to have a face-lift, that’s your prerogative.”

Though opting for these interventions is often framed as a personal decision, many experts say it’s hardly that simple.

“It’s important to think about how those choices are constrained and to think about the social pressures,” said Abigail Saguy, a sociologist at the University of California, Los Angeles. “This is a social issue. It is a collective problem. But it’s continually treated as an individual issue and what individual people should do.”

In some cases, as with drugs like Ozempic, these interventions can offer real health benefits. But as their use expands beyond medical need, questions arise about how medical resources are used.

Dr. Aasim Padela, who studies bioethics and Islamic thought at the Medical College of Wisconsin, thinks a broader conversation is needed. His primary issues are the ways in which the field of medicine suffers as a result and what resources are poorly distributed when cosmetic surgery is prioritized within a society.

“The profession is supposed to be about restoring health or preventing loss of health,” he said. “Certain types of procedures, body modifications, interventions — whatever you want to call them — may not meet those goals or even be aimed at those goals.”

Associated Press religion coverage receives support through the AP’s collaboration with The Conversation US, with funding from Lilly Endowment Inc. The AP is solely responsible for this content.

Dr. Michael Obeng, center, performs liposuction at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Dr. Michael Obeng, center, performs liposuction at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng makes body markings using a surgical marker to indicate areas to be treated before performing liposuction and tummy tuck procedures at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng makes body markings using a surgical marker to indicate areas to be treated before performing liposuction and tummy tuck procedures at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

A patient receives a Botox injection at a clinic in Arlington, Va., on June 5, 2009. (AP Photo/Jacquelyn Martin, File)

A patient receives a Botox injection at a clinic in Arlington, Va., on June 5, 2009. (AP Photo/Jacquelyn Martin, File)

Plastic surgeon Dr. Michael Obeng performs a belly bottom reconstruction plastic surgery after a tummy tuck at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

Plastic surgeon Dr. Michael Obeng performs a belly bottom reconstruction plastic surgery after a tummy tuck at a surgical center in Beverly Hills, Calif., on Thursday, Feb. 5, 2026. (AP Photo/Damian Dovarganes)

GENEVA (AP) — The cruise ship at the center of a deadly hantavirus outbreak and which is stuck off the coast of Cape Verde with nearly 150 people on board was waiting Wednesday to head to Spain’s Canary Islands. Meanwhile, health authorities in South Africa and Switzerland identified a strain of the virus that can be transmitted between humans in rare cases.

Three passengers have died and several others have been sickened by hantavirus on board the Dutch-flagged MV Hondius cruise ship. Hantavirus usually spreads by inhaling contaminated rodent droppings.

The ship left Argentina on April 1 on an Atlantic cruise and was scheduled to include stops in Antarctica, the Falkland Islands and other locations. However, the itinerary appears to have changed because of the situation on board.

The head of the World Health Organization, Tedros Adhanom Ghebreyesus, said three patients with suspected hantavirus cases have been evacuated from the ship and are on their way to the Netherlands.

He said the U.N. health agency is working with the operators of the cruise ship to closely monitor the health of passengers and crew.

“At this stage, the overall public health risk remains low,” he wrote on his X account.

Among the patients is the ship's doctor, Spain’s health ministry has said. The ministry said on Wednesday that the doctor, who was initially scheduled to be flown to the Canary Islands, is now being evacuated directly home to the Netherlands “after his health had improved."

Authorities in Switzerland also announced Wednesday that a man who returned from a trip to South America and traveled on the cruise ship has tested positive for the virus and is receiving treatment.

Spain’s health ministry said in a statement late Tuesday that it would receive the MV Hondius vessel in the Canary Islands after a request from the World Health Organization and the European Center for Disease Prevention and Control. Despite some opposition from leaders in the region, the government insisted that it would ultimately make the call.

For now the luxury cruise ship remains marooned off the coast of Cape Verde, an island nation off West Africa in the Atlantic. The World Health Organization said passengers are isolating in their cabins.

South African health authorities said they identified the Andes strain of hantavirus in two passengers who were on the ship, and Swiss authorities said they identified the same virus in their affected patient.

The World Health Organization says the Andes virus, a specific species of hantavirus, is found in South America, primarily in Argentina and Chile.

The Andes virus can be spread between people, though this is rare and the spread of the disease is typically contained because it would spread only through close contact, such as by sharing a bed or sharing food, experts say.

The South African Department of Health said its results came from tests performed on the passengers after they were removed from the ship and flown to South Africa.

One of the passengers, a British man, is in intensive care in a South African hospital. Tests were performed on the other passenger posthumously after she died in South Africa.

A statement from the Federal Office of Public Health said that the man “returned to Switzerland after traveling on the cruise ship on which there were a number of hantavirus cases.” It said his case also involved the Andes virus.

The Swiss health office initially said the patient hospitalized in Zurich had “returned from a trip to South America” with his wife at the end of April, without specifying. Simon Ming, a spokesperson for the office, clarified in an email that the patient got off during its stop in St. Helena, in the South Atlantic Ocean.

It was not immediately clear when that was or how he was returned to Switzerland.

The patient’s wife hasn’t shown any symptoms but is self-isolating as a precaution, the statement said.

The public health office said that “there is currently no risk to the Swiss public.”

The WHO said in a social media post that the man responded to “an email from the ship’s operator informing the passengers of the health event” and went to the hospital.

The cruise ship will be welcomed to Spain’s Canary Islands, according to Spanish authorities, as the vessel waited off the coast of West Africa for a third day Wednesday for sick passengers to be evacuated.

The regional president of Spain’s Canary Islands, Fernando Clavijo, said Wednesday that he was worried the arrival of the ship could put the local population at risk and demanded an urgent meeting with Spanish Prime Minister Pedro Sánchez.

“Neither the populace nor the government of the Canary Islands can rest assured because it is clear that the danger to the population is real,” Clavijo told Onda Cero radio.

The World Health Organization has said the ship had an itinerary that included stops across the South Atlantic Ocean, including mainland Antarctica and the remote islands of South Georgia, Nightingale Island, Tristan da Cunha, St. Helena and Ascension.

The cruise company has only announced some details of two stops: at St. Helena, where the body of the Dutch man suspected to be the first hantavirus case on board was taken off the ship. His wife also left the ship at St. Helena and flew to South Africa, where she died.

The company said a British man was later evacuated from the ship at Ascension Island and taken to South Africa, where he is in an intensive care unit.

The company has not said if other people left the cruise ship at those or other locations.

Asadu reported from Abuja, Nigeria, and Imray from Cape Town, South Africa. Renata Brito and Joseph Wilson in Barcelona, Geir Moulson in Berlin, and Mike Corder in The Hague, Netherlands, contributed to this report.

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

Health workers in protective gear evacuate patients from the MV Hondius cruise ship at a port in Praia, Cape Verde, Wednesday, May 6, 2026. (AP Photo/Misper Apawu)

A night view of the MV Hondius cruise ship anchored at a port in Praia, Cape Verde, Tuesday, May 5, 2026. (AP Photo/Misper Apawu)

A night view of the MV Hondius cruise ship anchored at a port in Praia, Cape Verde, Tuesday, May 5, 2026. (AP Photo/Misper Apawu)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)

An aerial view of the MV Hondius Dutch cruise ship anchored in the Atlantic off Cape Verde, Tuesday, May 5, 2026. (AP Photo/Arilson Almeida)

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