title: Supporting facial transplantation with the pillars of bioethics.
abstract: Facial transplantation has recently been offered to patients with severely disfigured faces not amenable to functional reconstruction with autologous tissues. Arguments against this procedure include risks of immunosuppression, the concern that it will be done for cosmesis, the belief that acceptable reconstruction can be achieved with autologous tissues, the potential impact on the patient of graft failure, and the concern that the procedure may be adopted by unqualified centers. If we look to bioethics to help us dissect the question of whether or not facial transplantation should be performed, we see that the majority of the arguments have been proscriptive rather than prescriptive. There are valid arguments in favor of facial transplantation based on the prescriptive pillars of bioethics: autonomy, justice, and beneficence. This article attempts to reframe the dialogue in a prescriptive manner.
authors.affiliation: Department of Plastic and Hand Surgery, Regions Hospital, St. Paul, Minnesota 55101, USA. loree.k.kalliainen@healthpartners.com
authors.forename: Loree K
authors.initials: LK
authors.lastname: Kalliainen
mesh_terms: D001675:Bioethics; D003657:Decision Making; D004992:Ethics, Medical; D005151:Facial Injuries / Q000601:surgery*; D054445:Facial Transplantation / Q000941:ethics* / Q000639:trends; D005260:Female; D005544:Forecasting; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D018579:Patient Selection; D011788:Quality of Life; D009927:Tissue and Organ Procurement / Q000941:ethics*; D014181:Transplantation Immunology; D014184:Transplantation, Homologous / Q000941:ethics; D014481:United States