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.



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