ok, that title might possibly have been in poor taste. I'm referring of course to the recent Face Transplant that took place in Lyon. I had a lecture about this type of medical intervention earlier this year in one of my bioethics classes, by one of the profs in the department here at Dal who was doing quite a bit of research into the possible ramifications of such a surgery, mostly surrounding personal identity. It was a very interesting lecture, and since the first transplant has now taken place, there is much discussion about it all. the article linked above provided a decent analysis of the issues.One of the key issues that has been raised is the psychological state of the recipient, who had the surgery because she was disfigured after a dog mauling incident. She admitted in a press conference to having attempted suicide before she was able to receive the surgery. The question is, whether she should have been considered a good candidate in light of her mental health status, and that perhaps the surgical team was less than ethical in choosing their candidate in order to win the race to be the first to perform such a medical intervention. My initial thought is that it is understandable that this woman had psychological trouble after the lower part of her face was torn off by a manic dog, and it is possible that without the surgery, she would not be able to make a pscyhological recovery.
Another key issue has to do with personal identity, and how a patient might understand him/herself after such a surgery – especially a full-face transplantation (the one done in Lyon was a partial-face transplant). What would it be like to wake up in the mirror and have a new face – not jsut a new one, but one that recently belonged to someone else? Of course, candidates for this surgery may have already gone through a drastic revision in personal identity, as the patient in Lyon had, from a disfiguring accident. But what if you had lived all your life with one type of face – an unusual face, perhaps due to a congential defect? What would it be like to have an unusual face, and then suddenly have one that is entirely different? Would a donor, who agrees to donate their tissue, really agree to donating their face – which is so tied to their personal identity? I am an organ donor, but I would have to give great thought to whether I would want to donate my FACE.
This type of case is most similar to hand transplantation – also first done in France, if memory serves me. There have been reports of patients rejecting their new hand because it didn't feel right, or look right, to them after all – and undergoing amputation to have the new hand removed. What if this happened with a face transplant, where identity is so closely knit together with facial appearance? It's not like they could walk around without a face – they would need another transplant in this case. Do we keep trying until they get one they are happy with?
so, what do you guys think?