Partial face transplant sparks ethics debate

PARIS – An ethics debate broke out over the world’s first partial face transplant Thursday with one surgeon challenging the decision to operate.

At the same time, several doctors raised concerns about the psychological health of the French woman who received a transplanted nose, lips and chin on Sunday. She had been brutally mauled by a dog in May.

Dr. Laurent Lantieri, an adviser to the French medical ethics panel, said the surgeons who operated violated the panel’s advice because they failed to try reconstructive surgery first. He said a transplant donor was immediately sought without trying to repair the woman’s face with more conventional surgery.

The panel had previously objected to full face transplants but said partial ones could be considered under strict circumstances, which included first trying normal surgery.

“The ethics committee said this kind of transplant should never be considered as an emergency procedure,” Lantieri said.

However, surgeon Denys Pellerin of the National Consultative Ethics Committee advised by Lantieri said, “as long as the transplant is not total, it is not unethical.”

Carine Camby, director general of the agency under the French Health Ministry that coordinates organ procurement, said normal reconstructive surgery could not have been used in this case.

“It is precisely because there was no way to restore the functions of this patient by normal plastic surgery that we attempted this transplant,” Camby said.

Camby also said the patient “received many psychiatric examinations. The psychiatrists decided that she understood the surgery and that she accepted all of the consequences, including the risk of rejection and of failure, the risk of immune suppression treatments and the need to take them for life.”