The aesthetic operations that the EPS must cover, according to the Court

The Constitutional court determined that cosmetic surgery procedures for functional or reconstructive purposes should be covered by the health system and, therefore, The EPS have the obligation to provide them.

This was explained by the Court after a ruling of a guardianship carried out by a citizen who suffered from hanging skin, this after having suffered morbid obesity and undergoing weight loss treatments. According to the court, Patients can request functional cosmetic surgeries if they have a doctor’s order ordering the procedure.

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“Constitutional jurisprudence has emphasized that such entities cannot deny the provision of these services on the grounds that they are excluded from the Health Benefits Plan, without demonstrating under medical concepts in the study of each specific case, that the requested procedures are for the purpose of beautification and non-functional reconstructive or emotional, psychic and social well-being“, stated in the judgment.

As it is, the Second Review Chamber of the Court, with a presentation by Judge Juan Carlos Cortésstudied the case of the citizen, finding that a professional who was not registered with the EPS to which she was affiliated, told her that she should undergo a breast reduction.

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At this, the woman approached the Secretary of Health of the department of Cesar Yet the new EPS to request the authorization of the procedures, but the entities denied them because they considered that the surgeries required by the patient were purely aesthetic, which are not included in the Health Benefits Plan.

The citizen insisted that the surgical procedures were necessary to overcome her health problems, since the excess skin caused irritation and even episodes of depression.

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Faced with this, the Court, already with guardianship in its hands, said that the New EPS had not made a diagnosis “serious and deep“, containing the reasons for denying the requested services.

This was due to the fact that there were insufficient medical arguments to conclude that the requested services had a purely aesthetic purpose. Given all this, the Court did not directly order the surgery requested by the citizen, but it did decree the EPS to carry out a rigorous examination to determine the origin of the surgical procedures that the woman would require based on her clinical status.

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“The EPS must support its diagnosis on scientific grounds. In any case, the plaintiff’s consent to be subjected to an assessment must be taken into account, as well as the jurisprudential rules contained in this decision on aesthetic surgeries of a functional reconstructive nature.“, the ruling concludes.

BRIEFCASE
*With information from EL TIEMPO – JUSTICE