If for nothing else, the surgeons performing elective surgery should assure that their patients are in good enough health that their life will not be in jeopardy if the surgery is elective. If the patient can prove that their health, both physical and mental, is good enough to understand the potential outcomes, then they can proceed with the elective surgery.
I think a person has to at least prove that they aren't a risk or more of a risk than would outweigh the benefits of the elected surgery before having it. Sometimes there are surgeries that are considered elective but that would be a huge benefit to a person's health and life. In this case, I could understand taking somewhat of a risk.
Patients rightfully expect their physician to have a general picture of their overall health and to only recommend elective surgery if the patient is healthy enough for it. In this system of PPOs and HMOs, many patients get lost in the shuffle and don't have a chance to develop long-lasting, open rapport with their doctor. In such cases, it is up to the doctor to do the investigative work to determine the patient's health at the time of the surgery. It's about time they took some responsibility for doing their jobs.
If you choose elective surgery and your body is not well enough for it, that is a decision that you alone should bear. Medical professionals can advise and provide information, but at the end of the day, anybody adult enough to choose plastic surgery or lap-band surgery can make their own final decision and bear responsibility for that decision.