[Medicine on demand?].

Modern medicine has left its central purpose to heal patients and has developed into a mere instrumental discipline which sees its central aim as fulfilling wishes instead of relieving suffering or treating illness. Aesthetic surgery is one of the many examples of such a transformation of modern medicine. This paper starts from the concept of medicine as a promise to help people who are suffering and who are in need of help. This aim of helping defines medicine. When it abandons this aim and merely fulfills wishes, medicine becomes a mere enterprise. Such a transformation is not illegal, but it will lose the notion of medicine as a moral institution based on trust. A closer look from an ethical viewpoint makes clear that the doctor who offers aesthetic interventions faces many serious ethical problems which have to do with the identity of the surgeon as a healer. Acting ethically means above all acting in the interest of the patient. One must therefore ask whether offering aesthetic interventions is really acting in the interest of the patient. Many arguments are presented to show that the interest of the patient and the moral integrity of medicine are in danger if medicine makes wish-fulfilling and aesthetics into one of its main tasks.