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This is a thought provoking paper but I wonder if it is founded on a false premise. It strikes me that a conscientious objection only applies if the surgeon has an obligation to undertake a cosmetic surgery procedure. If there is no obligation they are simply declining to carry out the procedure. Presumably this may be because the surgeon decides the procedure is not in the best interests of the patient. Since the surgeon is primarily an expert in physical, bodily function they should base their judgement of best interest on those grounds. Of course, if this reasoning is sound, fewer cosmetic procedures should perhaps be performed than currently are.