The New Frontier of Organ Transplants

We live in the exciting, yet frightening, world of modern medicine. Exciting? Oh yes. Potentially frightening? Without a doubt!

For example, one can rejoice in the extended longevity of family and friends whose lives have been saved as a result of organ transplants. Numerous good people have been bequeathed a new lease on life as the result of some generous donor who made a pre-death decision to donate usable, vital organs in the interest of a fellow human being.

Though there always have been risks associated with these procedures for the recipient, with respect to certain essential organs, e.g. the heart, liver, kidneys, lungs, etc., the risk of a transplant assuredly was better than the inevitable alternative — imminent death.

Beginning a few years ago, however, a new frontier began to be explored — that of transplanting non-vital organs, such as hands, the larynx, and, in a recent well-publicized case, that of a partial face.

In early December, a partial-face transplant was performed at a hospital in Northern France. A 38-year old woman, Isabelle Dinoire, had been mauled by a vicious dog that savaged her face, leaving her in a frightfully disfigured condition.

Although the Royal College of Surgeons in Great Britain, as well as the French National Advisory Committee, had previously issued warnings regarding the potential dangers in “face transplants,” surgeons at Amiens University Hospital went forward with the procedure a few months after the mauling incident. A portion of the face of a deceased suicide victim was used to reconstruct a part of Ms. Dinoire’s facial features.

Some physician/ethicists, however, are concerned about such procedures on several grounds.

First, they feel that this type of non-vital surgery may put the patient at greater risks in other areas, despite the cosmetic value of a transplant. For example, some of the medications employed to fight the immune system’s rejection oftransplanted material are believed to increase the risk of cancer. Too, there is the possibility of the development of diabetes in some cases (about a 10% risk). Serious endangerment for a mere esthetic enhancement may be ethically questionable.

Second, there is the danger that some scientists, eager to traverse uncharted medical territory, may take advantage of vulnerable candidates for optional transplant surgery. One physician has described the matter as like soliciting the proverbial fox to guard the henhouse. Is it not at least a little disconcerting that the surgeons who proceeded with the Dinoire transplant reconstruction disregarded the warnings of two prestigious medical institutes?

Third, in view of the uncertainty of such a radical procedure as a “face transplant,” who can foresee the potential psychological trauma that may result eventually, particularly in fragile people?

The whole of a person is worth more than a solitary, non-vital component.

Ethical physicians will take into account the entirety of a person, rather than exploiting the individual for the sake of a minute achievement that has perhaps more potential disadvantages than otherwise.

For more on this matter, we recommend an article by Dr. Gregory W. Rutecki, Director of Medical Education, Mount Carmel Health System, Columbus, Ohio. Dr. Rutecki is also a Clinical Professor of Medicine at The Ohio State and Wright State University Medical Schools and a Fellow of the Center For Bioethics and Human Dignity.See: “The Transplantation Revolution: From Vital to Non-Vital Organs and Finally to Faces?”