Ethical Concerns on Face Transplant Grow

NY Times ^ | December 6, 2005 | MICHAEL MASON and LAWRENCE K. ALTMAN

[neverdem]

In urgent telephone calls and agonized e-mail messages, American scientists are expressing increasing concerns that the world's first partial face transplant, performed in northern France on Nov. 27, may have been undertaken without adequate medical and ethical preparation.

Some scientists say they fear that if the French effort fails, it could not only threaten the life of the transplant recipient, a 38-year-old Frenchwoman, but jeopardize years of careful planning for a new leap in transplant surgery.

"We've been working on the ethics and the science for some time, going slowly while we figure out immunology and patient selection criteria and indications," said Dr. L. Scott Levin, chief of plastic and reconstructive surgery at Duke University Medical Center. "This flies in the face of everything we've tried to do."

The scientists' worries stem in part from the execution of the surgery, and in part from news reports over the weekend that called into question the patient's emotional state.

Dr. Maria Siemionow, director of plastic surgery research at the Cleveland Clinic, who has been preparing to perform a full face transplant, said that the way the transplant was conducted appeared to conflate two experimental protocols: the transplantation of facial tissue and the infusion of stem cells from the donor bone marrow into the patient in an attempt to prevent rejection of the new face.

The first procedure, although untried until now, has been well studied, and the microsurgical techniques involved are commonplace. But the second has been successful in human subjects only rarely and only recently. While pilot studies do suggest that an infusion of stem cells from the donor can help produce "chimerism" in humans, a state in which foreign tissue is tolerated by the body with comparatively little or no suppression of the immune system, it is far from standard...

[HairOfTheDog]

The reason for the face transplant had nothing to do with her alleged attempted suicide, and whether she should have been a good candidate has no bearing on whether the transplant works.

[Fintan]

I suppose abortion on demand doesn't require a dialogue about "ethics" from doctors...

[VRWCmember]

Is it too late for the doctors to save face on this issue?

[Vicomte13]

Peh, it's been done before anyway.
Hey, I saw John Travolta and Nicolas Cage go through this operation.
Old hat.

[PsyOp]

I saw a "face transplant" on the World Wrestling Federation once... dude echanged his face for a canvas mat. It was a hell of an improvement as I recall.

[carolinablonde]

I'm with you. I heard a so-called psychologist talking about this yesterday. She said that the patient "may not have been properly prepared to adjust to life with the new face". I guess it would be easier to adjust without a face? The poor woman couldn't even eat she had been injured so badly.

And how is it OK with the medical community for some Hollywood celebrity (or California Congresswoman) to have so much collagen injected into her lips that she looks like a blowfish but this surgery is "unethical"?

[US admirer]

"If she had her vagina transplanted on her face, then would it be sex?

That would depend on what the meaning fo the words vagina, face, sex and meaning mean?

[hocndoc]

Have you seen the fuss over at bioethics.net?

Those guys are snitty, but they're in a real snit over the press interest in other ethicist's snits.

[PeterFinn]

"Ethical concerns"?

We're talking about France here. They have no ethical concerns.

[Bones75]

"We've been working on the ethics and the science for some time, going slowly while we figure out immunology and patient selection criteria and indications,"

Well, clearly this woman who could not eat or speak is obligated to wait to have a FACE until you can get your bleauty sleep at night.

I say Bravo to the docs who went ahead with it.

[neverdem]

Tnanks for the link here and on the other thread.

[MeanWestTexan]

"Will 'ugly' people want 'pretty' faces as elective surgery?"

It wouldn't help much -- one's face is largely a factor of your bones. (Hence, why those CSI people can come up with a "photo" of a person from a skull.)

This lady will probably look much as she did, albeit a skin tone split.

[RightWhale]

There is apparently some transfer of memory that goes with transplanted tissue, especially the heart. A lot of people say 'nah, can't be,' but the more that transplant technology grows, the more evidence there is that this is happening. Memories can be very specific, including skills, talents, and names.

[GSlob]

Haven't the same [kind of] people - competitor wannabees - been foaming at the mouth when Barnard pioneered the heart transplants?

[GSlob]

You mean that the transplanted mouth would bring with it its [former] favorite profanities?

[Joe 6-pack]

"Is it too late for the doctors to save face on this issue?"

I think the bioethicists have been paying a lot of lip-service to this affair, but are afraid to put their money where there mouths are...I think the French physicians were aware that by doing this first, their rivals to be the first would be down in the mouth, but when one faces the facts, it's apparent that they only beat them by a nose.

[GladesGuru]

Abortion would seem to be primarily an ethical decision for the woman.

It can become an "issue" for others, for media, ad nauseam. But the actual decision is the woman's as she must make that decision.

[GladesGuru]

Sounds like the professional standards of Tom Lehrer's "Great Lobachevski" are alive and being practiced in France.

[hocndoc]

That's what Andrea Yates said.

[On the Road to Serfdom]

Rape would seem to be primarily an ethical decision for the man.

It can become an "issue" for others, for the victim, her significant others, for media, ad nauseam. But the actual decision is the man's as he must make that decision.
/sarcasm