"Facing the Future" and other bad puns

Recent announcements that two US medical centers are moving forward to attempt the first face transplant has led to headlines full of puns in newspapers across the country. But the announcement is anything but funny to those involved. People who have faces seriously disfigured by accidents are interviewing to become the first face transplant recipient at Cleveland Clinic. Though the surgery has been perfected on corpses, there are many unknowns facing the first live recipient. So many, in fact, that the consent form itself states that informed consent is not truly possible.

The consent form at Cleveland Clinic states:

• Your face will be removed and replaced with one donated from a cadaver, matched for tissue type, age, sex and skin color. Surgery should last 8 to 10 hours; the hospital stay, 10 to 14 days.
• Complications could include infections that turn your new face black and require a second transplant or reconstruction with skin grafts. Drugs to prevent rejection will be needed lifelong, and they raise the risk of kidney damage and cancer.
• After the transplant you might feel remorse, disappointment, or grief or guilt toward the donor. The clinic will try to shield your identity, but the press likely will discover it.

Since the first surgery is considered research, all expenses will be covered by the medical center. Recipients still have many other hurdles to overcome. The first of which is deciding if the potential benefits outweigh the burdens. A plethora of ethical issues are raised by this proposed transplant, some of which have been eloquently identified by Arthur Caplan. Perhaps the most important question is under what circumstances is it ethical to risk a patient’s life in order to push the envelope on a new scientific procedure? This question holds for any new medical development and the same host of questions were asked at the time of the first heart transplant. Today heart transplants benefit many patients and more patients are waiting for them than there are hearts available. So while the pun is bad, the question is real – what future do these people face?