Ethics Of Face Surgery Questioned

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Doctors who gave a French woman the world's first partial face transplant did not try normal reconstructive surgery first, violating the advice of a French government ethics panel, a surgeon familiar with the case said Thursday.

Dr. Laurent Lantieri also said he was concerned the patient may not be fit psychologically for the operation and its demands.

The 38-year-old woman, whose identity has not been disclosed, had surgery to replace her nose, lips and chin in Amiens in northern France on Sunday. The donor was a brain-dead patient whose family gave their consent.

Although the woman was mauled by a dog in May, surgeons immediately sought a transplant donor without trying to repair her face through conventional surgical methods, said Lantieri, a reconstructive surgeon.

"She had a complete amputation of both lips. The tip of the nose was amputated," he said.

"The ethics committee said this kind of transplant should never be considered as an emergency procedure," said Lantieri, who works at Henri Mondor Hospital in Paris, which is part of the federation of public hospitals in France. "You cannot have informed consent as an emergency procedure."

Lantieri said a surgeon in Lille who had seen the woman's medical record was concerned about her psychological suitability to endure the operation and adhere to the complex drugs needed life-long to ensure the operation's success.

The operation was done Sunday by ground-breaking transplant surgeon Dr. Jean-Michel Dubernard and Dr. Bernard Devauchelle. Dubernard led teams that performed a hand transplant in 1998 and the world's first double forearm transplant in January 2000.

The hand transplant recipient later had it amputated. Doctors said he failed to take the required drugs and his body rejected the limb.

Lantieri said he was fearful that this transplant could turn out like that first hand transplant if the patient is psychologically unstable.