Opinion and Editorial

What’s in a face?

Filed on December 5, 2005

THE first successful face transplant, performed on a severely injured woman in France this week, has revived the old debate about the medico-ethical merits and demerits of transplants. The medical fraternity is of course debating the issue from a professional perspective such as the long-term effects of such a transplant on a patient’s body and mind. Complications arising out of human body’s natural immunity that rejects a foreign element or tissue is a major source of concern for doctors.

This is why, to increase Isabelle Dinoire’s tolerance to a face that didn’t belong to her, she had to be given bone marrow from the donor as well as the standard immunosuppressive drugs, which are administered when other tissues and organs are transplanted. But these are not the issues that worry those outside the medical fraternity. There are many others —not necessarily the so-called ethicists —who see such transplants as a dangerous and totally unnecessary meddling with nature —a la stem cell experiment strongly opposed by religious groups. Many are not sure about the ethicality of planting the dead face of a very dead person on a living human being.

Transplanting of vital internal organs like heart and kidney has been accepted with some degree of reluctance by religious groups largely because it is often done in real life-saving situations. However, face transplant had been and is still seen by the majority of ethical objectors as absolute ‘no, no’. As top scientists at two prominent US universities have pointed out following the path-breaking operation in France, face transplants have been technically possible for several years. Only in the US, where ethical issues and concerns still dominate the scientific-medical discourse and establishment, they were seen as too drastic or too early for popular sensitivities. So it is no wonder that fiercest criticism of the French breakthrough has come from the scientific community in US. On the other hand, French scientists argue that the face transplant was absolutely necessary and will make a meaningful difference to Ms Dinoire whose face had been completely mauled by her dog.

The compromise formula, as always, may lie somewhere in between. While there is no doubt that face transplant must not be trivialised and turned into a fad, just as plastic surgery and enhancement of physical features with the help of silicon implants have been in the West. Face transplant, partial or otherwise, should only be resorted to as the last option and only when it can indeed make a vital difference to those who need it.

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