Facing a Tragic End: La Femme Aux Deux Visages

In the Science Times today, the NYTimes reports more on the first successful face transplant. It turns out that ethical considerations of transplanting a face aside (see my earlier piece on this), the donor had committed suicide and the recepient's disfigurement was a result of a sucide attempt.

Among the most disturbing aspects of the debate are conflicting reports from doctors about whether the transplant was the result of two suicide attempts, one successful by the donor, and one failed by the recipient.

If Ms. Dinoire's disfigurement resulted from an attempted suicide, it would raise questions about her emotional stability and her ability to consent to such a risky operation.

Reports that the donor committed suicide also have implications for Ms. Dinoire's future, because if true, and if the transplant is successful, it would mean that for the rest of her life, she would see in the mirror the nose, mouth and chin of a woman who herself met a brutal end.

The details of the story are profoundly tragic and have been the center of British tabloids.

One thing that haunts me about this article is the insidious suggestion that Ms. Dinoire (the patient) does not deserve this face transplant.

The Guardian reports that a French ethicist, Emmanuel Hirsch, is concerned that Ms. Dinoire was incapable of giving full consent to this operation, since her suicide attempt suggests that she is not "psychologically robust." Bioethics.net focuses on the consent issue as well. Informed consent is an important consideration in this matter, but I will leave those considerations for a different writer.

I cannot shake the impression that what also interests and horrifies the public, after the spectre of suicide and a suicide attempt haunts the operation, is that Ms. Dinoire might deserve to live with her disfigured face. (You can read the details in the NYTimes story how her face was disfigured in the first place.)

I suppose that if the patient had attempted suicide before her face was disfigured, then the story and concerns about consent would be different. A woman haunted and suffering because she has been born or suffered a legitimate tragedy might deserve better our pity.

It is not clear how one can best determine whether or not one who seeks a face transplant is capable of giving informed consent. To live with a disfigured face is a burden that few of us would choose to carry; it is a budr

What bothers me the most is how the donor's face projects a tragic end.

Reports that the donor committed suicide also have implications for Ms. Dinoire's future, because if true, and if the transplant is successful, it would mean that for the rest of her life, she would see in the mirror the nose, mouth and chin of a woman who herself met a brutal end.

If I were to sit in judgment of the board that approved this transplant, I would want to know more about how they reconciled giving the face of a haunted woman to another who is seeking peace.