@Nilitch:
Also no, ""medical explanation"" doesn't debunk ethics.
No, but reading up on why we avoid these things instead of saying "it's clearly unethical else everyone would be doing it" would be a good start. Especially with this assertion that ""medical explanation"" also doesn't include years of literature and discussion as to if we should do it.
What are you talking about here ? What is the lack of foundation for my arguments ?
Your complete lack of any sort of research into the subject matter leads to incredulous arguments and conclusions.
For example:
I've partially already answered this and your point is basically "it's normal now, wake up". Except that it's not "normal". The few transplants that have been done since 2005 are for research purposes. You can't go at the hospital and ask for a face transplant, you have to be selected by the ones who are doing research on it. That's why there are only 40 persons who underwent this procedure and not thousands and thousands. So no, it's literally not normal and it's been like that since 2005. For 13 years now, face transplants haven't hit the "public domain" (or however we put it, anyway, you understand what I mean here). And if it still did not, I have a little suggestion as to why–-- because they know it's fucked up.
They haven't hit the public domain because, as I explained earlier, turns out that transplants are really fucking hard, and you have specialists that deal with those matters. Criteria of which for a patient can even be a candidate for transplant surgery include: the donor and recipient must have compatible immune systems and the body needs to bleed to death and transplantation must be done within 24 hours of death.
I won't delve into the deeper facets of transplant rejection, but there's a reason why people are on donor match lists for ages. You're reading into something to fit your own (understandable but completely unjustified given the evidence) horror. And the reality of it is that grafting an entire face successfully is still pretty fucking hard. Like, even harder than putting a kidney in. We don't offer this sort of transplant regularly because of its difficulty and risks and the lack of infrastructure in place for it.
Relevant citations:
Immune rejection for face transplant is really fucking hard (2015): https://www.ncbi.nlm.nih.gov/pubmed/26505709
Not only is face transplant becoming a feasible option after getting beta tested, we're considering psych evals for it (2015): https://www.ncbi.nlm.nih.gov/pubmed/25699600
Proposals to say, hey, nurses and shit should probably be on top of their game for this (2015): https://www.ncbi.nlm.nih.gov/pubmed/26645925
If you mean, "it's very difficult and you can't change your face easily", I don't get how it changes anything that I've said. Yes maybe I have suggested that it could go out of hands and fuck up totally. But the main point has always been about one's face not being another's face.
And that has been debated on in the medical community and people at large for a very long time, such as since Face/Off came out. However, as Dr. Stephen Wigmore explains:
"Unlike the portrayal in the movie “Face Off,” in which John Travolta’s and Nicolas Cage’s characters trade facial appearances, a transplanted face would not closely resemble the donor, but would be a composite between their own features and that ofthe donor, Dr. Wigmore explained."
It retains some features given how skin and muscle are attached to the original donor, but the recipient's facial structure is going to be a strong determinant of the overall look of the face.
Ozmen et. al even states that "Face transplantation should still be a possibility for those who have run out of other options. As the results of the survey show, the more people are enlightened about the subject, the more accepting they are of the procedure. Also, the lesser the risks, the more optimistic they become. When faced with such a devastating situation, it is only normal for people to try to find a solution; therefore, it should be our principle to fully inform patients and try to give them the clear picture before they decide to undergo such a life-changing procedure. " People get a lengthy pre-op counseling before this sort of shit even happens, and it's unethical for us physicians to send patients to the hospital when 1) the surgery will force the rest of their life to be more prone to infections 2) it may not work, and 3) they may not want it.
It's because it isn't new that the medical community has discussed face transplants. Westvik et al "As for the ethical issues in facial allograft transplantation, the world has moved far past the question “if” this procedure should be performed and is refocusing on issues that not only concern face transplants, but also the entire field of VCA, such as costs, pediatric VCA, allocation, and donor-recipient sex matching."
Relevant citations:
Way back when face transplant was super hot and new, ethical challenges: https://www.medscape.com/viewarticle/520031#vp_2
Turkish people study if people would be willing to do face transplants: http://ovidsp.tx.ovid.com/sp-3.28.0a/ovidweb.cgi?T=JS&PAGE=fulltext&D=ovft&AN=00000637-201308000-00024&NEWS=N&CSC=Y&CHANNEL=PubMed
Brigham and Women's docs discuss their experiences with face transplants: http://ovidsp.tx.ovid.com/sp-3.28.0a/ovidweb.cgi?T=JS&PAGE=fulltext&D=ovft&AN=00000637-201505001-00002&NEWS=N&CSC=Y&CHANNEL=PubMed#76
Even then. And yes I'm conscious of what I'm saying.
Also, what do you have to actually say about the recipient looking like the donor ? Not for this case I linked, but for others. I have only checked a few, and I wonder if they always show a picture of the donor. If they don't I guess it'd be because they look very similar.
Cite your source because there's a preponderance of evidence that Rin is correct that, yes, bone structure is a pretty essential component of the perception of a face in the same way that people remark about how they have great bone structure or why apps like iPhone X's face ID is built entirely off of facial structure or Snapchat's filters oftentimes rely on identify facial structure to adjust the face.
You also can't get a consent from a deceased person to be published into a medical journal, and all data that you publish must be de-identified before you can publish. Especially to preserve anonymity for any surviving family members. Hell, publishing a face transplant recipient's post-op face also requires the same consent.
Source:
Facial structure and how people perceive you: https://www.scientificamerican.com/article/your-facial-bone-structure-has-a-big-influence-on-how-people-see-you/
But we're not going to do that.
Oh no, we certainly can.
For starters with Rin's NEJM article, the methodology they use does actually describe that they do actually give a fuck about ethical discussions, such as that they elect to move forward with the surgery "After extensive discussion of the indications, risks, and benefits, which included input from an ethicist" and that "Donor skin was tailored to the recipients’ defects for optimal contour. "
Furthermore, in the conclusion of the article, "We expected major immediate and gradual changes in facial appearance in these patients. We anticipated that the underlying skeleton and facial volume would shape the final facial appearance, making resemblance to the donors unlikely. It is our subjective opinion, as well as that of two of the donor families, that the patients do not look like their donors (the remaining donor family has chosen to remain unknown)."
It's also a reason.
But well, seeing how you're wording it, I guess you'd have been okay about it if it had any chance to succeed.
Success is measured in many ways. One of which is "did the patient survive the surgery?" Yes! Many surgeries are tested out rigorously to make sure that we know how this is even feasible, starting with animal models.
Next question: Did they survive for a long period of time? The mice that Canavero et. al experimented on died mostly within 36 hours of their experiment, which is a fucking horrible mortality rate especially if you want to sell people on the idea that you've got a good handle on the science.
Next question after that: In terms of long term outcomes, are their lives satisfactory? This is actually a hugely important topic these days given that palliative care may actually be a much more important thing instead of subjecting patients through painful procedures that barely increase life expectancy. In terms of a head transplant, this is where your question goes, and it could be a hotly debated topic… if it were actually feasible.
The science and bioethics for this is so, so finicky, and that's why Institutional Review Boards (IRBs) in the US and Europe are not going to approve this sort of thing seeing as he's basically jumping from Step 1 to Step 502 if he actually tries this with the poor Chinese prisoners that he likely will be experimenting with. Look, when it comes to clinical research, in the US, we actually have a very, very rigorous process (that's oftentimes actually kinda grating to go through sometimes given the bureaucracy behind it) that screens out incredibly questionable procedures based on how they affect human subjects, and IRBs (ironically given your comparisons to Mengele) were formed in response to the Nazi experiments as well as an actually horrible experiments that endangered human lives such as the Tuskeegee Syphilis experiments and the Stanford prison experiments. An IRB would never approve a head transplant because the science for it is basically non-existent and would be undue cruelty to the subject of the experiment given its high probability of failure as well as any other societal issues. Back in the day, bioethicists also asked the same question about doing research and potentially accidentally causing an incredibly virulent unstoppable superbug that would kill everyone. And we decided that we'd need to have safeguards behind it.
Today, we have a lot of bioethical questions as to what makes us human, whether a face contributes to the identity of self, and yes, there can be ethical quandaries behind it, but there is actually growing acceptance in many places as bioethically acceptable so long as we stick with it to only the worst possible cases. Even for more common transplants, when the procedures were first developed, there was of course a lot of discourse and dialogue as to whether or not we're stepping on God's domain with it, but we as a global society have accepted it and have argued in favor of the potential to do good while minimizing harm to patients and donors.
But it's completely absurd to base your arguments on this idea that face transplant is a game changer as to how we do this when we've not only been doing it for a decent amount of time but have thoroughly been debating it, with the general bioethical consensus being "we're cool with it, but only in the most extreme of cases". Other solutions simply do not exist for every medical problem, else we would not subject patients to painful procedures, debilitating chemotherapy, and other modalities to treat cancer (the treatment of which is also hotly debated in the bioethical community given long term outcomes versus quality of life). This is the reason why facial transplants, difficult procedures that expose patients to a long term risk of infections and cancer due to immunosuppression, are reserved for the worst of cases, also given the moral and ethical middle ground of this being the only way they'll really be able to have any semblance of a normal face.
And after considering everything here in terms of bioethics, this sort of statement is pure hyperbole:
This is the kind of fucked up stuff that usually take place in a State with very shady morals like North-Korea or China for instance. Or the kind of think Mengele would do. But now people believe that it's very good to graft a face on a head because the golden ass French are pioneer in that kind of surgery. Hey, as long as the surgeon is not a far-right winger it's somehow very much progressist. phew
And that's the crux of this whole thing. If there's any reason why I'm saying that your arguments stand on false ground, it's because it's the same sort of superfluous argument that anti-vaxxers go with without doing an actual ounce of reading besides sensationalist headlines and without actually vetting your sources. This "unethical" dilemma implies that these procedures are being done without any sort of ethical oversight, clear indications for which it's actually warranted, and dialogue and discourse among the medical community into societal and ethical questions. That, frankly, is absurd.
Relevant citations:
what the fuck is an IRB: https://www.brandeis.edu/ora/compliance/irb/101/history.html
Facial transplant started off as pretty sketchy but people are getting p cool with it medically for the worst things possible: https://www.ncbi.nlm.nih.gov/pubmed/24281583