Early in the nineteenth century, surgeons in Edinburgh excised a tumor from Robert Penman's lower jaw that had caused severe disfigurement of his face. A remarkable surgical innovation at the time, the patient not only survived but remained in excellent health for many years. Since then, phenomenal strides in composite tissue allograft have revolutionized reconstructive surgery. Success in hand transplantation prepared the way for the first partial face transplant in November 2005. These innovations are intended to optimize quality of life for a small, select group of patients whose “conditions cannot be adequately addressed by conventional reconstructive surgery procedures.”
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References
M. H. Kaufman, M. T. Royds, The Penman Case: A Re-evaluation, Journal of the Royal College of Surgeons of Edinburgh 45 (1), 51–55 (2000).
S. Hettiaratchy, M. A. Randolph, F. Petit, W. P. A. Lee, P. E. M. Butler, Composite Tissue Allotransplantation – A New Era in Plastic Surgery? The British Association of Plastic Surgeons 57, 381–391 (2004).
L. K. Altman, French, in First, Use a Transplant to Repair a Face, New York Times, December 1, 2005.
F. Petit, A. Paraskevas, A. B. Minns, W. P. A. Lee, L. A. Lantieri, Face Transplantation: Where Do We Stand? Plastic & Reconstructive Surgery 113 (5), 1429–1433 (2004).
R. G. Hartman, Face Value: Challenges of Transplant Technology, American Journal of Law & Medicine 31 (1), 7–46 (2005).
P. A. Clark, Face Transplantion: Part II-An Ethical Perspective, Medical Science Monitor 11 (2), RA41–RA47 (2005).
S. Baumeister, C. Kleist, B. Dohler, B. Bickert, G. Germann, G. Opelz, Risks of Allogeneic Hand Transplantation, Microsurgery 24 (2), 98–103 (2004).
J. Martin, Hand Transplantation: A Future Clinical Option, Acta Orthopaedica 76 (1), 14–27 (2005).
P. J. Morris, J. A. Bradley, L. Doyal, M. Earley, P. Hagan, M. Milling, N. Rumsey, Facial Transplantation: A Working Party Report From the Royal College of Surgeons of England, Transplantation 77 (3), 330–338 (2004).
L. K. Altman, A Pioneering Transplant, And Now an Ethical Storm, New York Times, December 6, 2005.
M. Lanzetta, P. Petruzzo, R. Margreiter, J. M. Dubernard, F. Schuind, W. Breidenbach, S. Lucchina, S. Schneeberger, C. van Holder, D. Granger, G. Pei, J. Zhao, X. Zhang, The International Registry on Hand and Composite Tissue Transplantation, Transplantation 79 (9), 1210–1214 (May 15, 2005); X. F. Aheng, G. X. Pei, Y. R. Qui, L. J. Zhu, L. Q. Gu, Serial Monitoring of Immunological Parameters Following Human Hand Transplant, Clinical Transplantation, 18(2), 119–123 (2004).
Associated Press, Woman Says ‘Merci’ After Face Transplant, New York Times, December 2, 2005.
X. Bosch, Surgeon Denied Ethics Approval for Face Transplantation, The Lancet 363, 871 (2004).
C. S. Smith, As a Face Transplant Heals, Flurries of Questions Arise, New York Times, December 14, 2005; L. K. Altman, A Pioneering Transplant, And Now an Ethical Storm, New York Times, December 6, 2005; E. Check, Surgeons Seek Go-Ahead to Perform First Face Transplant, Nature 431, 389 (September 2004).
M. Lanzetta, P. Petruzzo, G. Vitale, S. Lucchina, E. R. Owen, J. M. Dubernard, N. Hakim, H. Kapila, Human Hand Transplantation: What Have We Learned?, Transplantation Proceedings 36, 664–668 (2004).
F. Petit, A. Parcskevas, L. Lantieri, A Surgeon’s Perspective on the Ethics of Face Transplantation, American Journal of Bioethics 4 (3), 14–16 (2004).
A. M. Capron, Ethical and Human-Rights: Issues in Research on Mental Disorders that May Affect Decision-Making Capacity, New England Journal of Medicine 340 (18), 1430–1434 (1999).
D. Jones, Soon I May Have My Life Back, Daily Mail (London), June 27, 2004 (Interview with Jacqui Saburido).
I. Fukunish, Relationship of Cosmetic Disfigurement to the Severity of Posttraumatic Stress Disorder in Burn Injury or Digital Amputation, Psychotherapy and Psychosomatics 68 (2), 82–86 (1999).
C. Levine, R. R. Faden, C. Grady, D. Hammerschmidt, and L. Eckenwiler, The Limitations of ‘Vulnerability’ as a Protection for Human Research Participants, American Journal of Bioethics 4 (3), 44–49 (2004).
L. K. Altman, Patient Opted for Transplant as Method to Mend Face, New York Times, December 2, 2005.
M. T. Miliora, Facial Disfigurement: A Self-Psychological Perspective on the ‘Hide-and-Seek’ Fantasy of an Avoidant Personality, Bulletin of the Menniger Clinic 62 (3), 378–394 (1998).
F. Coull, Personal Story Offers Insight into Living with Facial Disfigurement, Journal of Wound Care 12 (7), 254–258 (2003).
R. Newell, I. Marks, Phobic Nature of Social Difficulty in Facially Disfigured People, British Journal of Psychiatry 176, 177–181 (2000).
P. Gorner, Surgery’s Next Step: Face Transplants, Chicago Tribune, June 12, 2005 (Interview with Christine Piff).
N. S. Jecker, Protecting the Vulnerable, American Journal of Bioethics 4 (3), 60–62 (2004).
C. Barnard, C. B. Pepper, One Life (Macmillan 1969).
C. Siebert, Making Faces, New York Times, March 9, 2003.
A. H. Moss, M. Siegler, Should Alcoholics Compete Equally for Liver Transplantation, Journal of the American Medical Association 265 (10), 1295–1298 (1991).
C. B. Terwee, F. W. Dekker, G. J. Bonsel, S. H. Heisterkamp, M. F. Prummel, L. Baldeschi, W. M. Wiersinga, Facial Disfigurement: Is It in the Eye of the Beholder? A Study in Patients with Graves’ Ophthalmopathy, Clinical Endocrinology 58 (2), 192–198 (2003).
C. S. Smith, As a Face Transplant Heals, Flurries of Questions Arise, New York Times, December 14, 2005; E. H. Morreim, About Face: Downplaying the Role of the Press in Facial Transplantation Research, American Journal of Bioethics 4 (3) 27–29 (2004).
R. La Ferla, N. Singer, The Face of the Future, New York Times, December 15, 2005.
M. A. Sanner, Transplant Recipients’ Conceptions of Three Key Phenomena in Transplantation: the Organ Donation, the Organ Donor, and the Organ Transplant, Clinical Transplantation 17, 391–400 (2003).
E.g., In re Tri-State Crematory Litigation, 215 F.R.D. 660 (N. D. Ga. 2003); Christensen v. Superior Court, 820 P.2d 181 (Cal. 1991); Colorado Revised Statutes Section 18-13-101 (2003); Pennsylvania Statutes Annotated title 18, Section 5510 (West 2004).
E.g., In re Moyer’s Estate, 577 P.2d 108 (Utah 1978); Ohio Revised Code Annotated Section 517.23 (West 2004); New York Public Health Law Section 4200 (McKinney 2004).
E.g., Indiana Code Annotated Section 35–45–11–1 (Michie 2004); New Hampshire Revised Statutes Annotated Section 644:7 (1996); Oregon Revised Statutes Section 166.087 (2004); Tennessee Code Annotated Section 39–17–312 (2003).
M. Verble, J. Worth, Fears and Concerns Expressed by Families in the Donation Discussion, Progress in Transplantation 10 (1), 48–55 (2000).
S. P. Kay, Editorial, Give and Take, The British Association of Plastic Surgeons 57, 379 (2004).
Uniform Anatomical Gift Act, 8A U.L.A. 19 (1993) (amended 1987).
United Network for Organ Sharing, Waiting List Deaths and Death Rates, at http://www.unos.org/SharedContentDocuments/Waiting_list_deaths_and_rates.pdf; R. A. Epstein, Organ Transplant: Is Relying on Altruism Costing Lives? American Enterprise (November–December 1993).
National Organ Transplantation Act, 42 U.S.C. Sections 273–274 (1994).
E. D. Pellegrino, Life or Death: The Issue of Payment in Cadaveric Organ Donation, Journal of the American Medical Association 265 (10), 1302–1306 (1991).
H. Hansmann, The Economics and Ethics of Markets for Human Organs, Journal of Health Politics, Policy & Law 14 (1), 57–85 (1989).
J. D. Mahoney, The Market for Human Tissue, Virginia Law Review 86 (2), 163–223 (2000).
M. Sandel, What Money Can’t Buy: The Moral Limits of Markets, in 21 The Tanner Lectures on Human Values 89 (G. B. Peterson ed., 2000).
P. Ramsey, The Patient as Person: Explorations in Medical Ethics (Yale University Press, 2nd ed. 2002).
E.g., Virginia Code Annotated Section 54.1–2986(B) (2004).
E.g., California Health & Safety Code Section 7100.1(a)(1) (West 2004); Minnesota Statutes Section 149A.80 (2003).
E.g., Cruzan v. Harmon, 760 S.W.2d 408 (Mo. 1988), aff’d sub nom, Cruzan v. Director, Mo. Dep’t of Health, 497 U.S. 261 (1990).
R. G. Hartman, The Face of Dignity: Principled Oversight of Biomedical Innovation, Santa Clara Law Review 47 (1), 55–91 (2007).
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Hartman, R.G. (2008). Ethical and Policy Concerns of Hand/Face Transplantation. In: Hewitt, C.W., Lee, W.P.A., Gordon, C.R. (eds) Transplantation of Composite Tissue Allografts. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-74682-1_30
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DOI: https://doi.org/10.1007/978-0-387-74682-1_30
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