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Justifying surgery’s last taboo: the ethics of face transplants
  1. Michael Freeman,
  2. Pauline Abou Jaoudé
  1. University College London, London, UK
  1. Correspondence to:
 Professor Michael Freeman
 University College London, Bentham House, Endsleigh Gardens, London WC1H 0EG, UK;uctlmdf{at}


Should face transplants be undertaken? This article examines the ethical problems involved from the perspective of the recipient, looking particularly at the question of identity, the donor and the donor’s family, and the disfigured community and society more generally. Concern is expressed that full face transplants are going ahead.

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  • i Cover story of the New Scientist, 29 May 2004.

  • ii See also The Guardian, 28 November 2005. The recipient gave an interview in the Daily Mail, 10 December 2005: 1, 20, 22. It had been reported that 12 people were queuing in Cleveland, Ohio, USA, to be chosen for the first transplants according to The Times, 19 September 2005: 13. See also The Guardian, 19 September 2005: 15.

  • iii Also reported in The Guardian, 16 December 2005:1.

  • iv A point made by Hedley J. In: W and BvH [2002] 1 FLR 1008, 1009. He refers to “an imbalance between our scientific and ethical capacities”.

  • v Note the Louisville team’s reliance on Moore FD. We surely cannot be alone in having missed his 1988 and 1989 articles which feature prominently in reference 1.

  • vi Re M [1999] 2 FLR 1097, 1100.

  • vii This is based on a presentation at the Annual Meeting of the Association of Plastic Surgery in Seattle in 2002 by Banis et al.

  • viii We do not know what the respondents were told, and there is sparse information regarding their social profile.

  • ix According to the Royal College of Surgeons, “any surgeon contemplating performing facial transplantation should regard the procedure as experimental and subject it to the evaluation of an independent committee” (Royal College of Surgeons in England,5 p 17).

  • x A point made by Toombs K. What does it mean to be somebody? Phenomenological reflections and ethical quandaries. In Leder,44 p 73.

  • xi See BIOMED II project “Basic Ethical Principles in European Bioethics and Biolaw” 1995–1998.

  • xii R v Human Fertilisation and Embryology Authority ex p. Blood [1999] Fam 151.

  • Competing interests: None.

  • The origins of this article are a Master’s Dissertation submitted to the University of London, London, UK, in 2004 by PAJ and a paper presented to the International Association of Bioethics, 7th World Congress, Sydney, Australia, in November 2004, as well as to a staff research seminar in the Law Faculty of University College London, London, UK, in October 2004 by MF. Another paper on face transplants was presented to the Congress and is published as Huxtable R, Woodley J. Gaining face or losing face? Framing the debate on face transplants. Bioethics2005;:–22 . Neither was MF present at this presentation, nor, so far as is known, were the authors of the Bioethics article present at MF’s presentation.