Thursday, December 01, 2005

What's In A Face?

" . . . in the isolated close-up of the film we can see to the bottom of a soul by means of such tiny movements of facial muscles which even the most observant partner would never perceive. A novelist can, of course, write a dialogue so as to weave into it what the speakers think to themselves while they are talking. But by doing so he splits up the sometimes comic, sometimes tragic, but always awe-inspiring, unity between spoken word and hidden thought with which this hidden contradiction is rendered manifest in the human face adn which the film was the first to show us in all its dazzling variety."

~Bela Balasz, "The Close Up"

The French have succeeded in performing the first face transplant in Amiens (see also this link at The female patient had her faced disfigured when a dog attacked her, and consequently enjoys a life of suffering and alienation. I was surprised to learn that she was the first recepient of a face transplant. Somehow, when I imagined the ideal candidate for this type of surgery it was someone like Lucy Grealy.

The ethical questions concerning face transplants are fascinating and push us to consider : what is it in a face?

The University of Louisville is planning their own face transplant, and making certain that this operation will be wholly ethical. Of course, one could argue that at some fundamental level a face transplant violates the most stable of ethical entities involved in any ethical discussion.

Emmanuel Levinas, a French Jewish philosopher, founded an entire theory of ethics around the symbolic and real relationship of the face-to-face. A person's humanity is to be found in her face. Writing after the Holocaust, wherein so many were capable of objectifying and stripping the humanity of their fellow human beings, Levinas essentially points out that act of genocide is an act of denying human transcendence, denying that you are facing another human being who, like you, has aspirations, hopes, dreams and can act on the world to transform it. Human beings are not things. This insight is not to be demonstrated in a Kantian deductive proof, but rather can be realized in the face-to-face encounter with another human being.

Our face is inextricably linked to our identity; through our face others find our humanity, identify us as the same person over time, and judge our worth. We fall in love with the contours and details of a face. Parents often know every scar or every mole on their child's face. Lovers know the lines that mark each others years together or the odd shape of ears, noses or lips.

Through our faces we can reveal our innermost secrets or keep all others at bay with the "poker face."

I am amused and yet not surprised by the ethical issues that the French ethics committee raised over face transplants:

Face transplants, the committee said, should not be performed on an emergency basis. One reason, it said, is because "the very notion of informed consent is an illusion," even if all standard techniques have been exhausted, a candidate patient insists on receiving the transplant and a donor is available. "The surgeon cannot make any promises regarding the results of his restorative efforts, which are always dubious," the committee said. The report continued, "Authentic consent, therefore, will never exist."

If any of you have studied French philosophy as much as I have, you will be amused by the notion of "authentic consent." It is a gloss on consent unique to French sensibilities. The emphasis on authenticity is not just a question of whether or not one is sufficiently self-possessed and rational to make an informed choice for another's face. To stress authenticity, especially in the wake of Jean-Paul Sartre's notion of humanity, is to stress the importance of making choices that are not influenced by the social reward, or the demands of others. Such considerations are bad faith. One cannot, in this framework, ever choose to mend a disfigured face in connnection with the human project of becoming most authentically oneself.

While I do think there are fascinating issues bound up with faces and identity, I also think we need to consider whether a "rugged authentic model" is indeed compassionate. Our face is a window to our soul. Whether or not it actually reveals the secrets of our inner divinity is less interesting to me. But, the capacity of the face to speak our humanity is an inescapable, experiential fact of human existence. It may indeed be the condition for the possibility of ethical community. Hence, to upbraid one whose face is disfigured and hence whose access to human community is diminished, as inauthentic should she choose a facial transplant is, well, inhuman.