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First Face Transplant

mriya3 writes to tell us the BBC is reporting that surgeons in France have performed the first ever face transplant. The medical team, led by Jean-Michel Dubernard, transplanted live tissue to a 36-year old woman whose face had been destroyed by a dog. From the article: "It has been technically possible to carry out such a transplant for some years, with teams in the US, the UK and France researching the procedure. [...] But the ethical concerns of a face transplant, and the psychological impact to the patient of looking different has held teams back."

28 of 446 comments (clear)

  1. Ethical concerns? by Eric+Smith · · Score: 5, Insightful
    What ethical concerns?

    A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

    And how could the "psychological impact" be worse than not havin a face? The patient is going to "look different" no matter what is done.

    1. Re:Ethical concerns? by Chmarr · · Score: 4, Insightful

      Yeah, I thought that was kind-of daft too.

      "Oh, I can live with having a mauled/disfigured/destroyed face, but I CANT live with having someone ELSE's face".

      Yeah... right.... :)

      However, doing the ID thing would be interesting from then on.

    2. Re:Ethical concerns? by garcia · · Score: 2, Insightful

      A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

      According to the article, that you apparently didn't read: "In the controversial operation, tissues, muscles, arteries and veins were taken from a brain-dead donor and attached to the patient's lower face."

      "Brain-dead" doesn't mean the donor wasn't alive.

      It added that the woman - who wishes to remain anonymous - was in "excellent general health" and said the graft looked normal.

      This was nothing more than a skin graft. If it weren't for the "ethical implications" of taking someone else's healthy tissue from their *face* this would have been a non-issue.

      Move along.

    3. Re:Ethical concerns? by Eric+Smith · · Score: 4, Insightful

      The article failed to explain why it couldn't be someone that died very recently (within minutes). In a hospital, there are people dying all the time, so finding a donor that isn't on life support doesn't seem completely impossible. Just somewhat difficult.

    4. Re:Ethical concerns? by Anonymous Coward · · Score: 1, Insightful

      A live person is missing a face. A dead person doesn't need theirs any more. Where's the problem?

      According to the article, that you apparently didn't read: "In the controversial operation, tissues, muscles, arteries and veins were taken from a brain-dead donor and attached to the patient's lower face."

      "Brain-dead" doesn't mean the donor wasn't alive.


      From an ethical standpoint, brain death - irreversible cessation of brain activity - is considered a valid definition of clinical death (by nearly all medical establishments), since there are numerous circumstances where the body can be sustained indefinitely via technology, although the brain is a complete "flatline" forevermore.

    5. Re:Ethical concerns? by tomhudson · · Score: 3, Insightful
      and the psychological impact to the patient of looking different

      It doesn't take much brains to realize that someone's going to look different after having their face chewed off by a dog. I should think having a strangers' face is less traumatic than seeing your own looking like a barfed-up big mac.

      Better a stranger's face than a strange face.

    6. Re:Ethical concerns? by pdamoc · · Score: 2, Insightful

      Technically, face transplants are not medically necessary. From a physiological point of view you are right BUT we are both physiologic and psychological beings. When healing the healer tries to improve one, the other or both. A patient without a face might be at a very low psychological level even if from a physiological point of view she is ok so... healing is needed.

    7. Re:Ethical concerns? by Scoth · · Score: 3, Insightful

      Some people consider their identity to be extremely personal, including their appearance. I know a few people who would likely prefer "Disfigured, but it's me!" over "some other guy". I personally would probably go with the transplant if the situation ever came up, but it's definitely not a universal assumption to be made.

    8. Re:Ethical concerns? by ScentCone · · Score: 3, Insightful

      Wull, mghuh-hmm-srtch-hmmm.

      Sorry, I couldn't quite get that out - I was finishing a hamburger. You know, putting some foreign tissue into my body. I think it's pretty obvious why... wait... [smack!]. Sorry, I had to swat a mosquito. It was busy getting some of its fluids into my body. In fact, that reminds me of how I was in an elevator this morning respirating the same damp air as the other ten people in there. Other people's exhalations, microbes, viruses and all!

      Look, you stand way more of a chance of getting a disease from sitting on a public toilet than you do from a highly scrutinized tissue transplant. In fact, you could just as easily die from an anti-biotic-resistant lung infection picked up environmentally while you're in the hospital having your own blood transfused back into you.

      I think you doth protest too much, and that your issue is strictly a superstitious one, similar to those that prevent people from donating their loved ones' perfectly good organs after an accidental death. I'm always amazed that people would rather bury a good liver in the ground (or burn it) than let some poor kid get a new lease on life. But I'm even more amazed by someone who would rather die than take in an organ from a screened donor. That's OK though - helps us evolve more rational people.

      --
      Don't disappoint your bird dog. Go to the range.
    9. Re:Ethical concerns? by cloudmaster · · Score: 2, Insightful

      I think we should get the "business" out of the healthcare business before we worry about whether or not the government should be involved. :)

  2. I'm confused.. by RapmasterT · · Score: 4, Insightful
    No seriously, what exactly are the "ethical considerations" of a face transplant? What makes it more ethically significan't than a skin transplant anywhere else?

    And the "psychological impact" to the patient of looking different?? Looking different from a hideously scarred accident victim? Isn't that why they want surgery in the first place?

    This seems to me like a story desperately in search of sensationalism.

    1. Re:I'm confused.. by RapmasterT · · Score: 2, Insightful

      Considering that forensic anthropologists and pathologists recreate facial structures from bare skulls all the time, I think it's safe to say that the overlying skin plays far less of a part than the bone structure. Pigmentation and texture may be different, and some fatty deposits may change, but overall the person should look pretty much the same. Or at least as "same" as a person who gains/loses a lot of weight.

    2. Re:I'm confused.. by RapmasterT · · Score: 2, Insightful
      Ever seen the faces on the post office wall? Or on the side of a milk carton? Or mug shots or headshots used in a pictorial line up or even a real line up?
      Ok, I gotta ask.

      What the hell are you talking about? What does any of that have to do with face transplants?

      Are you suggesting criminals would use this to hide from prosecution? Not only is the appearance change likely to be minimal (since the bone structure is the same), but nothing stops them from having plastic surgery RIGHT NOW.

      You sound like one of those nuts who thinks cloning should be illegal because they won't have souls and will be evil.

    3. Re:I'm confused.. by BarryNorton · · Score: 4, Insightful
      No seriously, what exactly are the "ethical considerations" of a face transplant?

      And the "psychological impact" to the patient of looking different?

      It's about having, to some degree, someone else's face.

      This is also why they're at pains to point out that the recipient does not look exactly like their donor.

      Just as people look back and can't understand why people were uncomfortable with the idea of someone else's blood running around their veins, or someone else's heart beating in their chest, so people might get over this idea - you apparently have.

      Have some imagination, though, and see why people have (it's true, and well-documented, not just sensationalism) been creeped out by this idea for decades...

  3. Ethical concerns.... by stunt_penguin · · Score: 2, Insightful

    "The ethical concerns of a face transplant...."

    Someone's already supposedly cloned a human embryo. I wouldn't worry about facial transplants too much.

    --
    When the posters fear their moderators, there is tyranny; when the moderators fears the posters, there is liberty.
  4. you dont look the same by jmazzi · · Score: 4, Insightful

    Even if you got a face transplant, you wouldn't look like the face of the donor. Your bone structure etc is what makes up most of your appearance. Although, you wouldn't like you use to. So I don't see how ethics would really take a roll in this matter.

  5. Re:Wow by blamanj · · Score: 2, Insightful

    While everyone makes a big deal about Face/Off, because they took the idea of a face transplant literally, the idea of surgery making you look like someone else has been around for quite a while.

    For example, in Arsenic and Old Lace, one of the plot points involved a criminal whose looks have been altered to resemble Boris Karloff. In the stage play, this part was actually performed by Karloff.

  6. Re:Government and Health Care by pnewhook · · Score: 4, Insightful
    The same Canada that just voted their Congress out of office?
    Congress was not voted out of office. The opposition got together and forced the government to resign (a vote of non-confidence). This is extremely democratic - moreso than in the US where you are essentially stuck with the guy for four years, unless you actually manage to impeach the guy for something criminal.
    The same Canada that almost killed a friend of mine whose plane was grounded on 9/11, got a stomach flu and almost died in a Canadian hospital while he waited THREE DAYS for a doctor to see him?
    If it was just a stomach flu why didn't he just go to a walk-in clinic? He would have been assessed (for free) and had a prescripion in under an hour. If it was more serious, he would have been referred to a hospital that would then have been notified that he would be arriving and be ready for him.
    The same Canada where people are on waiting lists for years for a basic MRI that I can drive down the street here in the States and get in a mere hours?
    Years? Give me a break. I do agree that the wait time is long, and a huge issue, but it is on the order of weeks not years. Also if it is high priority, then there is no wait time - the scan gets done immediately.
    The Canadian health care system is a mess. I pray I am never doing business in Canada when I get ill.
    Funny, most people I know pray they don't live in the US when they get ill, as a major illness effectively means bankruptcy.
    --
    Tesla was a genius. Edison however was a overrated hack who liked to torture puppies.
  7. Psychological impact? by idommp · · Score: 5, Insightful

    I grew up with one-quarter of my face missing in action. When I was two, doctors removed the upper left quadrant of my face including the eyelids and the skin down to the bottom of my nose. Twenty operations and fifteen years later I finally got working (but not very pretty) eyelids again. The person undergoing the face transplant has already suffered the psychological impact of loosing their original face and the impact of being treated like some kind of monster. The trauma of getting a different face can't possibly be any worse.

    1. Re:Psychological impact? by Tim+C · · Score: 3, Insightful

      The person undergoing the face transplant has already suffered the psychological impact of loosing their original face and the impact of being treated like some kind of monster.

      That really depends on the circumstances. I imagine that a lot of these operations would be performed immediately or very soon after the injuries were sustained (eg burns victims, etc). They may well still be adjusting to the idea of being disfigured, and - if the operation was performed soon enough - may not have had any contact with anyone other than medical staff, friends and family.

  8. Re:Wow by arootbeer · · Score: 2, Insightful

    You say this as if you think it is

    a) easy to kidnap someone worth swapping faces with, including someone who has other similar physical characteristics (some are easier, e.g. body style, hair color; some are difficult, e.g. extreme height or weight differences, skin color)
    b) an easy and painless procedure that doesn't require months of healing
    c) easy to find a doctor who has the necessary skills who doesn't already have more money than you could possibly offer to perform the procedure for an illicit reason
    d) easy to reprogram your personality and habits to blend in in the places where the person whose face you "swapped" with yours would be known or well-known (what's the point of stealing someone's physical identity if not to gain access to the places that person would normally have access to, but which you do not?)

  9. Re:Government and Health Care by 0xA · · Score: 2, Insightful

    The population of Gander Newfoundland is about 10k people, on 9/11 there was about 10k people stranded there for a few days. Was that where your friend got stuck? Things were, naturally, a little messed up with trying to feed and shelter that many people. Sorry about that but do you really think some remote outpost in Alaska caould handle taking care of that many people much better? Next time feel free to have all those planes circle over the ocean until they run out of fuel. http://www.snopes.com/rumors/gander.htm

  10. Not at all true. by Marc2k · · Score: 3, Insightful

    Did you know that in the US in 2006, more children will grow up in homes that have declared bankruptcy than will grow up with divorced parents?

    Did you also know that as of 2004, over 50% of all bankruptcies in the US are directly related to a major medical illness somewhere in the family?

    50% Medical Bankruptcy article (2005)
    Article stating number of bankruptcies in 1999 (~ 500,000 families)
    Article stating number of bankruptcies in 2001 (~ 1.5 million families)

    --
    --- What
  11. Re:Government and Health Care by mr_matticus · · Score: 3, Insightful

    I'm with you 100% on personal responsibility, but I think you'll have to agree that other major Western democracies with healthcare systems do not produce these results. Canadians are much slimmer than Americans, as are the people in all of the EU states. The United States is one of the only (or maybe THE only) Western democracy without funded healthcare programs for its citizens. 65% of Americans are overweight or obese now. There's not really a causal relationship there, though.

    Fat and wasteful are becoming almost objectives in and of themselves for the "average" American. I don't think a functioning health care system in the US would lead to fatter people. I do think that people would continue getting heavier and lazier, but not having to pay out of pocket isn't the cause. Being American is the cause, with the mentality that has come to be dominant in our country.

  12. Re:Whoa, whoa, whoa by dada21 · · Score: 2, Insightful

    Thanks. In offense of myself, I hae to admit that I am unreasonable. My views of anarchocapitalism are hard to understand, but I have spent years testing them.

    I _would_ abe willing to try a government of anyone if we were guaranteed a few things:

    1. A 100% gold-backed currency. Wars are fought and corporations are built on counterfeit money.

    2. No politician serving more than 15,000 citizens. I think I'd rather have one representative who knows me rather than 35 who don't.

    3. No law can pass without 73% of the vote.

    4. No law can be more than 150 words.

    5. All laws must sunset after 4 years.

  13. Re:Whoa, whoa, whoa by blincoln · · Score: 2, Insightful

    Socialized health care is the rot of the world

    I would argue it's capitalistic health care.

    My insurance hasn't turned to shit over the last two years because of socialism. It's because the "not for profit" insurance companies have decided they need hundreds of millions of dollars in profit every year, and have found any number of ways to achieve it, including:

    - Raising co-payment fees
    - Covering fewer prescription drugs
    - Limiting prescription drug coverage to a certain number of doses per month
    - Adding asinine requirements to prescription coverage, e.g. if my doctor prescribes me certain drugs, they have to fax in a form to prove they really want me to take it... you know, the same thing the prescription slip says.
    - Limiting payments to specialists

    The last one is the worst. Because insurance companies limit their payments, specialists seem to be raising their fees so that they end up making what they should from insured patients. If you're not insured, you pay the ludicrous full fee. In addition, because the specialist fee goes up, the co-payment amount does too if (like me) you're responsible for a percentage of it.

    Hospitals and drug companies have jacked prices up into the stratosphere, also because they are capitalists trying to make as much money as possible. I went in to have my tonsils out a year ago, and some of the highlights of the bill were:

    - Hundreds of dollars for the per-minute "recovery room" fee. Did I ask to be anaesthetised enough that I'd sleep in there for an extra hour?
    - Five hundred dollars for a probe that was a piece of plastic with a tiny steel rod embedded in one end.
    - Three hundred dollars for the disposable bits that attached me to the oxygen sensor.
    - Hundreds more dollars for the generic painkillers. Morphine costs pennies to make, and so does everything else they used.

    In the end, even though I have insurance, I ended up paying about $200 EACH to the hospital, anaesthesiologist, and surgeon. And I *still* had to buy the pre- and post-op medication at my local pharmacy.

    I fail to see how anyone would think it would be better in a free market. Where is the incentive to lower prices, instead of (like now) conspiring to jack them up?

    Canada's health system has its problems, but it's better than ours. At least up there little girls who have tumors on their face the size of a grapefruit don't get denied care because they can't afford it.

    --
    "...always new atoms but always doing the same dance, remembering what the dance was yesterday." -Richard Feynman
  14. Re:So that's how by h4rm0ny · · Score: 2, Insightful


    What better way to undermine democracy in the West?

    --

    Aide-toi, le Ciel t'aidera - Jeanne D'Arc.
  15. Re:Wrong by Anonymous Coward · · Score: 1, Insightful

    The reason it's tearing itself apart is because the government for the past 13 years has used medicare ONLY as an issue to attack their opponents. They are not interested in solutions, because ALL solutions to the problem (other than throwing money at the problem, which is what has been done thus far - to no effect) would involve shifting towards somewhat privatized health care (they literally are not, at least in Saskatchewan, interested in so much as contracting out the housekeeping services because they have too much to lose by admitting that privatization of services is not *in and of itself* a bad thing, as long as the goal is still universal and GOOD, or at least acceptable, coverage).

    They go on and on about the "fairness" of people jumping the queue, without regard to the fact that the people with the money to do so are already going out of country to get those services, and that Canadian doctors and nurses are leaving the country for jobs elsewhere. They don't realize that having a parallel private system is NOT a zero sum game, because at least some of those doctors and nurses would be attracted by the hospitals, and the money that used to be spent on out of country hospitals could remain in Canada's economy.