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Sunday, December 6, 2009

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Is a face transplant ethical?

Being the extremely superficial person that I am, naturally I've been thinking a lot about the first U.S. face transplant. (Who wasn't obsessed with Isabelle Dinoire, the French woman who received the first partial one in 2005 after her labrador mauled her when she OD'd on sleeping pills? (Um, yeah, Jesus.)) It's astounding. Of course, part of the fascination stems from the fact that we can all identify with these women, on a few levels at least. The human face is so intensely personal--it's a bit more important than a kidney. And this seminal moment has precipitated a national dialogue about the breakthrough's ramifications: Should organ donors consider the fact that their face might be used in this way?

And well, the questions keep on coming. Some experts have raised ethical concerns regarding these kinds of surgeries in general. Is it cosmetic, considering the fact that this is not a lethal defect? Given the extremely high risk of rejection, how do doctors justify the need to operate? Do concerns regarding the social ostracism of the severely disfigured experience on a day-to-day basis outweigh the medical risks? There are clear psychological implications. Indeed, the patient underwent intense questioning and mental diagnosis designed to weigh the potential effects of living with a cadaver's face.

Related: Cheek implants a growing appeal for women young and old.


The debate isn't brand spanking new. After all, high falutin' medical ethics committees in England and France once ruled that the surgery risks outweighed the benefits. But that was a few years ago, and obviously technology has advanced, and well, in some ways you have to wonder if the prevalence and social acceptance of plastic surgery doesn't play some role here.  

Not to state the obvious, but human reactions to disfigurement are innate--the recent transplant recipient claimed that children cried when they saw her--so it's easy to understand how a patient would be absolutely desperate to achieve some degree of normalcy no matter what the cost. In some ways, social acceptance, or "fitting in," is something to be achieved at all costs, to the vast majority of us anyway. That's just human nature. But what if she had died as a result of the insanely complicated 23-hour procedure? (Doctors took different shifts so they could rest in between.) While the medical practitioners involved are currently being lauded for their success, would charges  have been leveled against them had they failed?

I honestly believe it was the right thing to do. Certainly in this situation, where the subject could not eat or breathe properly, there were legitimate reasons to operate. But going forward, how will these decisions be made? Where will the line be drawn? Personally, I would like to have the option, and I'm happy and relieved for this woman and hope that the result is that her life is vastly improved. That's where I stand anyway.  But it's not a black and white issue, now is it?

Of course, I have one more question: How do you feel about it?

For more news in the world of plastic surgery, check out the Scalpel News section over at allure.com.

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From the Community…

Comments 1-8 of 8
  • springtime's Avatar
    Posted by springtime Mon Dec 22, 2008 1:21pm PST

    I think it's just fantastic! So many men and women stay hidden after fires, a gun shot to the face, an animal attack, contact with acid, flesh eating bacteria, and the list goes on. Why not give them that opportunity to love,work, and participate in their communities again?

    Yes, it is a costly and long operation. But so is separating co-joined twins, which often takes over 30 hours and several doctors.

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  • Monique's Avatar
    Posted by Monique Mon Dec 22, 2008 2:41pm PST

    I'm with springtime. Why not give them that option? They will have to go through a serious questioning process as stated above so they know the full ramifications and the possibility of death.

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  • DeAnn's Avatar
    Posted by DeAnn Mon Dec 22, 2008 2:44pm PST

    I don't think its unethical at all. The face has to function, after all. For one thing, it helps with communication immensely. Someone who's face is so badly damaged they cannot speak has got to be dehumanizing for them. It is giving them a chance to regain a part of their body lost, just like any amputee jumps on the chance to have a prosthetic limb. What about Jaqui? The girl from the drunk driving posters? I remember seeing her on a talk show once talking about how she had never had a guy take a second look at dating her since the accident, and she was extremely popular beforehand. She has issues speaking, blinking (until one of her more recent surgeries) and is constantly plagued with the risk of infection.

    I think for people who have been badly disfigured by accident or war or cancer, there should be recourse for them. This surgery is an immense step forward for medical science. We can't sit back and say "just don't discriminate" because it's more than that. It has to do with function in daily life, being free from infection, and being able to communicate properly. It increases confidence and ability to interact with others - so much about communication is non-verbal. I don't think it's unethical at all.

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  • G's Avatar
    Posted by G Mon Dec 22, 2008 4:27pm PST

    I think it's a wonderful gift. There are so many people suffering because of being disfigured. It's a chance to feel good about themselves. I can't wait to see what the future will bring.

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  • vlvolove's Avatar
    Posted by vlvolove Mon Dec 22, 2008 10:26pm PST

    It isn't exactly "Mission Impossible" I mean if the ethical problem is the "face" transplant... What I mean to say is it isn't like you will look like the person that you received the transplant from. The receipient will still have their own bone structure under neath. I think even calling it a face transplant is media stirring up crap. It is just a transfer of skin...

    It's not like this is going to create a black market for donated pretty faces or anything.

    Facial disfigurement is so tragic... and even agood and decent person will have a hard time not being scared or startled by some one with it.

    We all think.. what if that happened to me?

    I say transplant away... If the individual is prepared for the risk...

    What could possibly be unethical about improving someones quality of life?

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  • culturallycool's Avatar
    Posted by culturallycool Wed Dec 24, 2008 9:14am PST

    I think that some people with scarred faces and other severe facial problems could benefit from it.

    http://www.culturallycool.com

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  • Rae's Avatar
    Posted by Rae Wed Dec 24, 2008 7:19pm PST

    Anything that can add to the quality of life that is not offensive to another person unless disclosed is ones own buisness. Think about it this way, if someone had a face transplant and you couldnt tell and it improved thier overall health what would it matter to anyone else? Other than showing the advancement of medicine. Usually in order to obtain a face or other body part, you would have to obtain consent, or have the donor be registered. Vanity aside, its a great thing and essentially a private matter unless the person wants to share that they are a recipient. Take Care-Rachel.

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  • ♥sunshinelady♥'s Avatar
    Posted by ♥sunshinelady♥ Wed Dec 31, 2008 11:16am PST

    I think It's great. I'm happy that they can do this.

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Comments 1-8 of 8

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