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Should Doctors Transplant Faces ?


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  #1  
October 15th, 2004, 02:43 PM
Heavenly's Avatar Super Mommy
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A Stranger in the Mirror: Should Doctors Transplant Faces?
By ERIC F. TRUMP and KAREN MASCHKE

Published: October 12, 2004


his year is the 50th anniversary of the first successful human organ transplant. Over the last half-century, the improved understanding of how to prevent the body's immune system from rejecting foreign tissue has turned what began as an experiment into a routine procedure. Today, bone and bowel, heart and hand are replaceable.

Now we are confronting the imminent possibility that human faces will be transplanted. This month in The American Journal of Bioethics, a team of transplant surgeons at the University of Louisville announced their intention to pursue the transplantation of faces. Last year, a task force at the Royal College of Surgeons of England cautioned against them.

The British group concluded that "until there is further research and the prospect of better control of complications, it would be unwise to proceed with human facial transplantation," a procedure that requires review board approval.

The Louisville transplant team, on the other hand, led by Dr. John Barker, argued that caution was a form of dawdling. As Dr. Barker told New Scientist magazine: "Caution by itself will not get us any closer. If Christopher Columbus were cautious, I'd probably be speaking with a British accent."

Still, we should be wary of crossing certain frontiers. We now have the ability to excise a face, including nose cartilage, nerves and muscle, from a brain-dead body and suture it to the hairline and jaw of a living person with a disfigured face.

Such a procedure repels and fascinates in equal measure. The face is not like other organs. It twitches, smiles, pouts and squints. It is how we express ourselves to others, and how others recognize us as who we are.

But as grotesque as placing one face over another may seem, surgeons and ethics review boards must confront more than just the "yuck factor" before they enter an international face race, with at least five teams working toward the first face transplant.

Transplanted organs, including the skin (the body's largest), survive because patients are given powerful anti-rejection medications. These drugs can have very toxic side effects, including cancer, kidney failure, diabetes and high blood pressure. For most transplants, the risks of immunosuppression are worth the benefits: the alternative to living without, for example, a lung or liver is death.

But millions of people have learned to live with facial disfigurement, either privately or with the help of counseling. Since disfigured people must try to come to terms with their new appearance anyway, will adjusting to someone else's face be any easier?

Counseling and skin grafts may not be as adventurous as radical surgery for such patients, but at least we know they work, and the risk to patients' survival is minimal. What are the contingency plans if a face transplant fails, for example? About 10 percent of organ recipients reject the transplant within the first year: imagine the horror of losing your face not once, but twice.

Given that a face transplant is not crucial to survival, the risks are simply too great to assume. Ethics review boards would do well to remember the history of hand transplantation. The very first hand transplant was a failure because the patient stopped taking his medications.

In 2003, a group of hand transplant surgeons argued, in an article published in The New England Journal of Medicine, that such transplants should be offered only to people who had lost both hands or were blind because the possibility of rejection and the dangers of anti-rejection medications were otherwise too great.

The lack of empirical evidence or long-term studies on face transplantation means that obtaining informed consent for this experimental procedure is highly unlikely. And even if consent is given, where will face donors come from? We are already in the midst of an acute organ shortage, with over 85,000 people on the national waiting list, suggesting an endemic unwillingness among Americans to donate their flesh, even in death.

How many people can we reasonably expect to give up one of their - or their loved one's - most symbolic body parts? Many funerals call for open caskets, and people typically request that the undertaker preserve the face. Before we find face donors, we may first have to reform our death rituals to ease the discomfort that removing faces will generate.

Dr. Barker argues that caution hinders surgical advancement. But what is more important: winning the face race? Or upholding the principle of "do no harm," as the British team suggests?


Eric F. Trump is a science writer and the associate editor of The Hastings Center Report. Dr. Karen Maschke isthe associate for ethics and science policy at the Hastings Center.
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  #2  
October 16th, 2004, 09:45 AM
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Uh..I can see the good in that (for burn victims and whatnot) but it SERIOUSLY icks me out.
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  #3  
October 16th, 2004, 09:54 PM
Heavenly's Avatar Super Mommy
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how would you feel looking in the mirror & not seeing you, but a dead person ?
I couldn'r donate a loved ones organs, but their face ?!

I couldn't do it.
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  #4  
November 2nd, 2004, 08:29 AM
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Hey if they want to by all means. Makes my stomach turn though. It could however do a lot for burn victims and other folks with facial deformities.
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  #5  
November 13th, 2004, 06:03 AM
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I saw a show on discovery health last weekend about that.............for burn victims it would be an answer. I just can't imagine looking in the mirror with someone else's face on me. Makes the movie Face Off almost to real.
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  #6  
January 10th, 2005, 08:00 AM
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I know somebody who, has a "plate" in his left side of his face due to a birth defect, if it was neccesaarry to take a dead persons face and place it some body else that is just sickly. I mean I'm not a big fan of plastic surgy, but jeez if I was burned really badly i'd rather have plastic surgery than have a dead persons face, that is just sick.
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  #7  
January 15th, 2005, 09:45 AM
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Something to think about......Helping a person would be a good thing!
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  #8  
January 15th, 2005, 03:42 PM
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When I die someone can have my face and my organs! I don't think I'll be needing them.

I think if you had a face transplant it wouldn't look like the dead person. Wouldn't the skin take the shape of the persons bone structure that received it? A whole head transplant might be a little freaky....... I actually think that an arm or leg transplant would be stranger to me. Especially until you trained your brain how to control it. Just IMO! After all, if you recieve a skin graft when you are severly burned they first use cadiver (dead person!) skin grafts so they can be removed and the underlying burned skin removed as it dies. You receive your own skin grafts once the burned area is ready to receive the permanent grafts. Or so they say on the discovery channel........
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  #9  
February 14th, 2005, 12:38 PM
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Quote:
Originally posted by holly76@Nov 13 2004, 08:03 AM
I saw a show on discovery health last weekend about that.............for burn victims it would be an answer.* I just can't imagine looking in the mirror with someone else's face on me.* * * Makes the movie Face Off almost to real.
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For burn victims, plastic surgery is not always an option. The skin tightens to the point of contortion. That is why these doctors are looking for donor skin. I also saw this on Discovery Health. The idea that this person would look like your loved one ridiculous. The recipient would still have their own bone structure under the donor skin. I don't think it is any different than a heart transplant or kidney transplant. If I had a severe facial deformity, I would definitely consider this option.
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  #10  
February 19th, 2005, 08:13 PM
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I really can't say what I feel. I know that I could not receive one. And could you imagine seeing your dead uncle walking around?
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  #11  
February 21st, 2005, 08:05 AM
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Quote:
Originally posted by LoriJack+Feb 14 2005, 02:38 PM-->
Quote:
<!--QuoteBegin-holly76
Quote:
@Nov 13 2004, 08:03 AM
I saw a show on discovery health last weekend about that.............for burn victims it would be an answer.* I just can't imagine looking in the mirror with someone else's face on me.* * * Makes the movie Face Off almost to real.
<div align="right"><{POST_SNAPBACK}>
For burn victims, plastic surgery is not always an option. The skin tightens to the point of contortion. That is why these doctors are looking for donor skin. I also saw this on Discovery Health. The idea that this person would look like your loved one ridiculous. The recipient would still have their own bone structure under the donor skin. I don't think it is any different than a heart transplant or kidney transplant. If I had a severe facial deformity, I would definitely consider this option.
<div align="right"><{POST_SNAPBACK}></div>
[/b][/quote]
Again, the person would not look anything like your uncle. His skin is not what makes his face, it is his bone structure. On that Discovery show, they transplanted faces onto cadavres (to experiment) and showed the cadavres of the donors and resipients photos to med students and the students could not identify who had received which face. It simply does not work that way.
If you have ever known or been close to a serious burn victim, you would know the importance of this development. Alot of people out there would love to have this surgery rather than be horribly difigured and afraid to leave their homes. To say that it "icks you out" is a ridiculous argument. Think about the people it would help!
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