Wednesday, March 05, 2008

The Beginning of Face Transplants in the U.S.

Last year WBP discussed the first-ever, medical breakthrough face transplant in 2005, that transformed the quality of life for a French woman mauled by her pet Labrador retriever. That patient—whose *new* face is now known to the world—as well as the identity of the donor—is doing well and healing nicely according to her doctors, successfully surviving tense and repeated tissue rejection episodes. To see the progress made by Isabelle Dinoire is nothing short of a miracle.

Now, the first hospital in the U.S., Boston’s Brigham & Women's Hospital, has been given the green light to start performing face transplants. The approval comes from the New England Organ Bank, the oldest independent organ procurement organization in the country. According to the agency’s website, only patients whose faces have been severely disfigured by skin cancer, burns or trauma will be considered as potential candidates for the surgery. In addition, the candidate must also be a current kidney transplant patient, already on anti rejection medication. Conditions likely to limit the candidate pool considerably. Critics have already begun lining up to voice concerns over the ethics of a non-life saving surgical procedure that could clearly put patients’ lives at risk.

Arguably, the importance of the procedure leaves little to question. What does pose questions, at least for this writer, is what the ethical implications of this groundbreaking surgery could be for the recipients of the surgery, as well as for the donors and families of the donors in terms of privacy.

Would HIPAA issues come into play? Having a face transplant poses different issues and/or risks in terms of privacy for both recipients and donors, unlike other types of transplant surgery. How will governmental agencies address—and remedy the likely privacy issues that will arise with restored patients walking around with easily identifiable (perhaps) body parts from an unfortunately deceased donor.

What if the donor—or recipient—is a celebrity? Or is a minor? What are the protections in place regarding privacy for both sides? What are the patient’s rights…what are the donors—and how would current privacy laws be modified or changed to accommodate a new surgical frontier? Do one group’s rights supersede the others? These may seem like sophomoric questions, but I wonder nonetheless. In the case of the first recipient from France, none of the parties involved appears overly concerned at this stage about issues of privacy. However, in the United States where matters of “whose business is it anyway?” and where concern—and sometimes outrage—over keeping medical information confidential is ever-increasing, what would be the real-world medical ethics that come into play here? And—would there be differences in how those ethics would affect patients on a gender scale? Much to ponder.

Read the full article here.

No comments: