A hard reality to face
Face transplantation presents a bioethical dilemma. Like other organ transplants, there is a risk that the body will reject it. To prevent this, patients are placed on immune-suppressing drugs, and often must continue this medication throughout the rest of their life. So face transplantation may lead to a shorter lifespan. But for the few people who so far have undergone the procedure, that is a worthwhile tradeoff.
Mary Rhee from the University of Maryland, Baltimore County, presented both the medical and the philosophical/psychological implications of this procedure today during the NUBC conference. On the philosophical/psychological side, the discussion began with the emphasis on the inherent “worth” of the face, in that it is an integral part of human identity. This is one reason why this is such a difficult bioethical issue, as a beneficial procedure that comes with so much baggage.
For some, the benefits far outweigh the loss of years of future life. Consider Isabelle Dinoire, a woman whose face was so severely mangled by a dog attack that she was largely unable to eat, drink, or even talk. Her wounds proved irreparable through the use of conventional reconstructive surgery. Hers is an easy case. But what of people who have facial scars that have no direct effect on their health and functions beyond social interaction?
Face transplantation is an excellent example of a core bioethical question. What is medicine’s purpose, to elongate life or to improve quality of life? Where should the balance be struck?
–Richard Blissett
March 20th, 2009 at 9:41 am
There’s an exceptionally well-written book entitled “Autobiography of a Face” by Lucy Grealy who underwent scores of surgery beginning with removal of a portion of her chin bone and face because of cancer as a child. Now dead, she wrote with great insight, honesty and lucidity about her experiences and feelings as she navigated childhood, the medical world and adult relationships. Arthur Frank, in “The Wounded Storyteller”, discusses narrative ethics using her story and others as examples. Both make excellent reading when you have a spare moment to think about faces. These are classics in Literature and Medicine courses.