Press reports indicate that a leading American medical center, The Cleveland Clinic, is ready to start an experimental program in human face transplantation. This represents a host of truly ominous and complicated ethical issues, ranging from what would happen once a transplanted face is rejected by the body’s immune system to how the surgery could be abused by those who would like to choose another identity.
Beyond this, the surgery is so experimental that informed consent — a foundation of modern medical ethics — is not even possible.
From The Guardian [London]: Proponents of face transplants argue that the procedure could remove the need for years of operations by applying a new sheet of skin in one operation. While the capability to perform face transplants has existed for years, nobody has attempted it. Teams of surgeons in Britain, France and the US have previously announced that they are close to performing face transplants, but concerns over the ethical implications of the procedure have halted or delayed their plans.
Although the Cleveland Clinic team has won approval from an internal review board, critics say an independent review board should determine whether the procedure can go ahead.
Last year a team at the University of Louisville in Kentucky, which had successfully transplanted a human hand, decided not to go ahead with face transplants after examining the ethical issues.
More: Opponents are most concerned about the possibility of rejection of the transplanted tissue and cultural and ethical problems. They are also concerned that the procedure, if successful, could be exploited for cosmetic surgery. Should the recipient’s body reject the transplant, it raises the possibility that the patient will be left worse off than before.
Many critics also question whether a person already traumatised by facial disfigurement would be equipped to cope. Although the Cleveland Clinic tells prospective recipients that it will do its best to shield their identity, it concedes that the press will probably discover it. The clinic also tells patients that the risks are so unknown it does not think informed consent is possible.