Arguing the Ethics of Facial Transplantation

Abstract

While 7 face transplants have been performed around the world, to date, there remains debate regarding the validity of this procedure. We submit that performing a facial transplant-in the appropriately selected patient-is technically defensible and ethically sound. By outlining the technical and ethical boundaries of the debate, responding to the key arguments against the procedure, and describing its motivations and potential benefits, we state our justification of facial transplantation.

The Ethics of Facial Allotransplantation: A Systematic Review

“…In all 148 articles included, nonmaleficence was the most frequent ethical principle addressed (117/148, 79.1%), 1–3,7,10–121 followed by beneficence (116/148, 78.3%), 1–3,5,7,10,13–24,26–29,32–42,44,46,48,49,51–56,58,60,61,63–66,69–84,86,87,89–93,95–137 justice (103/148, 69.6%), 2,3,5,7,11,14,17–22,24–28,30–32,34,35,38,39,41–44,46,48,49,51,52,54,55,57,58,60–64,66–73,75–77,79,82–85,87–92,94,95,97–102,104,105,107–112,114,117,119–121,123,125,129–131,135,138–147 and autonomy (86/148, 58.1%). 1–3,5,7,12…”

Cost Analysis of Conventional Face Reconstruction versus Face Transplantation for Large Tissue Defects

“…Many articles have pointed out the ethical considerations of performing an elective procedure that requires lifelong immunosuppression to treat a non-life-threatening condition. 26,27 An ideal analysis would incorporate the inherent risks of immunosuppression (including infection and malignancy) and the cost of immunosuppression. Although there are not currently enough data to know what these medications cost each year, there are published comparisons in kidney and hand transplant patients that range from $6000 to $20,000 per year depending on the drug regimen.…”

10 Ethics in Facial Plastic Surgery

“…But patient selection, patient lifelong immunosuppressive therapy, adequate informed consent, cost, and reimbursement present challenging potential issues. 18 Part of the Hippocratic Oath encourages physicians to try to "do good"; therefore, giving a horribly disfigured patient an opportunity at having an acceptable face seems clearly ethical. 19,20 Physician Qualifications:…”