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Report sets out blueprint to tackle global ethical issues around face transplants

Report sets out blueprint to tackle global ethical issues around face transplants

Posted on 30 May 2022

With close to 50 face transplants carried out in 11 countries around the world to date, a new report addresses the urgent need to set a standard of care to ensure the procedure is ethical and as safe and effective as possible for patients.

Artwork credit: Lucy Burscough

The report, led by the University of York and King’s College Policy Institute, is designed as a guide to help doctors and surgeons make decisions on if and how they should go ahead with face transplant procedures.

With contributors including doctors, psychologists, ethicists, historians and mental health professionals from 19 countries, the report strongly recommends that individual patient circumstances and perspectives should be at the heart of all clinical decisions.

Complex

Lead author of the report, Professor Fay Bound Alberti, from the Department of History and the AboutFace Project at the University of York, said “Just because we have the clinical expertise to perform a face transplant doesn’t always mean we should. The need for immunosuppressants means that the procedure is likely to shorten a patient's life and there are multiple ethical considerations which run deeper than deciding whether the procedure is clinically viable for an individual. For example, we must consider how a patient will cope with the complex emotions surrounding this surgery; whether they are well-informed about the outcomes to expect; how they will be supported in dealing with likely media attention, and the ongoing financial and physical costs.

“A face transplant can make all the difference to the quality of life of a person with a severe facial injury, but it's important that wherever in the world the procedure is being considered, medical teams have guidance on how to ensure patients are at the centre of decisions.

“The expertise of researchers from arts and humanities disciplines, alongside the expertise of those from the fields of science and medicine, has played a vital role in bringing patient perspectives to the fore in this blueprint.”

Concerns

A face transplant is yet to be carried out in the UK. In 2003 the Royal College of Surgeons published a report concluding the procedure should not be performed, due to multiple unresolved ethical concerns.

The blueprint aims to tackle those concerns by addressing six key themes - Patient selection and expectations; Patient support; Clinical framework; Data on patient progress & outcomes; Public image & perception, and Financial sustainability. The themes were set by the lead authors of the report based on qualitative research with face transplant patients, carried out as part of the AboutFace project at the University of York.

Pioneering

Professor Vijay Gorantla, President of the International Society for Vascularised Composite Allotransplantation, said: “The policy lab is a pioneering international attempt to develop expert consensus guidelines on issues spanning program, patient, policy, provider, and payer aspects of face transplantation. It focuses on safety and efficacy, cost coverage and value of interventions, access and equity, ethics and standards of practice”.