Science Fiction and The Face Off Over Full Face Transplant Surgery

August 31, 2012 § Leave a comment

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Richard Norris, before and after his face transplant surgery. Photograph from Reuters.

Die Another Day, the 2002 installment in the James Bond franchise, is not especially renowned for its emphasis on scientific accuracy. The climax of the film is the revelation that the villain underwent gene therapy to give himself an entirely new face in a secret clinic in the Caribbean (the location conveniently giving Bond girl Halle Berry ample opportunity to romp around in a bikini while chasing bad guys). While this cinematic plot twist is more fantasy than science, in reality surgeons have recently been making advances in face transplant surgery. In March of 2012 Richard Norris received a full face transplant at the University of Maryland Medical Center, replacing his entire face from hairline to collarbone after serious disfigurement from a 1997 gunshot wound. Although this procedure restored him to a normal life and gave him the confidence to re-enter society, it has prompted serious controversy about its ethics. Face transplants require organ donation from a person still technically alive on life support, though in a non-responsive, vegetative state. The new face is a compilation of the donor and the receiver’s original face, since facial features are determined by the outer layer of skin and underlying skull structure.

However, the future of face transplant surgery could be interesting to explore through science fiction. This surgery was previously opposed in Europe by the Royal College of Surgeons in the UK and by the French National Ethics Advisory Committee due to ethical concerns about performing such a dangerous procedure for purely cosmetic reasons. Technique might advance to the level where ordinary patients might choose to go under the knife to become more beautiful, creating unreal standards of beauty. What would happen, for instance, if a famous person went into the non-responsive state required for donors? Could someone else assume their face?  Although the patient is not supposed to end up with the donors’ exact looks because of bone structure, in theory if two people had similar features it could be possible in the future that someone could have a dead person’s face. Already transplant recipients have to be carefully screened because of the strong link between the face and identity. Psychological trauma can occur due to the shock of externally becoming someone else.

So possibly the Bond villains’ assumption of a new identity is not so far-fetched, after all. The revolutionary advance from partial to full face reconstruction could have fascinating criminal, societal, and psychological ramifications that should be developed in science fiction.

Katy Cesarotti

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