Facing the Ethics of Face Transplanting

The ethics regarding the transplant of a face from a dead donor to a living person who needs an intact and functioning face to replace a face severely damaged by trauma or otherwise disfigured is one which goes beyond any ethical considerations of other bodily organ transplants, such as heart, liver or kidneys.

The procedure as 2008 is ending is still experimental and facial transplants on humans have, as yet, been only partial and perhaps only in a few publicized cases at most. The problems of full functionality and rejection has yet to be met. Beyond that is the social, psychologic and ethics involved in considering and actually carrying out such surgery.

To learn more about the details of these considerations, read the 2006 American Society for Reconstructive Microsurgery and the American Society of Plastic Surgeons Guiding Principles for facial transplantation.

Setting the discussion of the ethics of facial transplantation, the American Society for Reconstructive Microsurgery in their 2006 position paper wrote:

The ethics of facial transplantation go beyond the life and death issues common to most transplants and engage other topics that heretofore have not influenced medical decision processes. The face represents the most identifiable aspect of an individual’s physical being and is central to communication. One might expect that a facially deformed patient is markedly impaired, but most studies confirm that the severity of deformity does not necessarily correlate with distress. Most patients with facial deformity adapt quite well and accept their physical appearance as “self”. The psychology of acquiring another person’s identity is very complex; the psychology of losing that newly acquired identity can only be imagined. Similarly, the psychologic repercussions of a facial transplant on family and friends of both donor and recipient cannot be underestimated. The ethics of inflicting an untried, and potentially fatal or deforming remedy for the purposes of advancing science must be carefully weighed against the Hippocratic credo of doing no harm. Those against facial transplantation argue that the desperation of disability never justifies the infliction of a hopeless remedy. Proponents of facial transplantation argue that selected patients who seek improvement in their quality of life in certain circumstances are prepared to assume risks to achieve it. Answers to these ethical issues can be easily manipulated to comport with most viewpoints. In the final analysis, however, ethics must be regarded as a means for discussing the issues of facial transplantation and not, necessarily, for resolving them.

What is your opinion regarding further research or if surgical and immunological problems can be overcome to have full facial transplant become a standard procedure for patients with facial disfigurement? ..or even for just for a simple cosmetic attempt to “look better”. Finally, what does a persons face mean to you and should it be only their own? ..Maurice.