Bioethics.net

Embargoed for release until September 17, 2004
News from Taylor & Francis and The American Journal of Bioethics

INTERNATIONAL RESEARCH TEAM DEFENDS ETHICAL GUIDELINES FOR FUTURE FACE TRANSPLANTS

LOUISVILLE, Ky. – An international research team studying the face transplant has developed guidelines it says are critical to the success of the still-untried procedure.  This important announcement and its rationale are the focus of the forthcoming issue of The American Journal of Bioethics (Volume 4, Number 3), published by Taylor and Francis.

Today’s scientists have the skills and experience to transplant a human face but they also need to consider the wide array of ethical and psychological issues involved, argues the team of researchers at the University of Louisville in Kentucky and Utrecht University in the Netherlands.

“These guidelines are aimed at stimulating professional discussion and debate,” said John Barker, M.D., team leader and director of plastic surgery research at the University of Louisville. “We feel the ethics of a face transplant need to be openly discussed before it is performed.”

Although the hopes, anxieties and emotional stability of transplant recipients have always posed ethical concerns, such issues are even more critical in face transplants, said Osborne Wiggins, Ph.D., a philosophy professor and epidemiology and clinical investigation science associate at U of L who was lead author on the article.

“What is at stake is a person’s self-image, social acceptability and sense of normalcy,” Wiggins says.

The team’s article in the forthcoming issue of The American Journal of Bioethics, “On the Ethics of Facial Transplantation Research,” is accompanied by critiques from more than a dozen leading bioethicists, psychologists, reconstructive surgeons and others. “The risks involved in undertaking the first clinical face transplant are staggering,” writes respondent Arthur Caplan, Ph.D., Professor and Director of the Center for Bioethics at the University of Pennsylvania.  “It is not certain that the transplant will provide a functioning or even partially functional face. The drugs required to maintain a transplanted face are powerful, noxious, and potentially life-threatening.”

Face transplants would be offered to those disfigured by trauma, burns, tumors, infections, or congenital defects, the authors say. Currently, surgeons try to reconstruct these patients’ faces by transplanting tissue from other sites on their bodies or by implanting prosthetic devices.  Face transplants may actually pose fewer surgical complications than existing methods used to repair severe facial disfigurement, and recipients would be less likely than organ transplant recipients to develop organ toxicity from anti-rejection drugs, the team suggests.

However, because facial appearance is so closely associated with one’s sense of personal identity, the recipient of a face “must adapt … to this new ‘identity’ as well to other people’s responses to it.”

It is also vital that the institution performing a face transplant be free of possible conflicts of interest such as financial reward or professional gain, the team concluded.

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The full Target Article and peer commentaries are available to members of the media immediately.  Please contact Kelly Carroll at The American Journal of Bioethics, media@bioethics.net (email) or 267.979.2096 (phone).

For more information on the authors, please call Denise Fitzpatrick at University of Louisville, 502-852-6171 (phone).

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AJOB and Taylor and Francis begin a new publishing partnership with this forthcoming issue. Published quarterly, the journal is the most widely read and most cited publication in the field of bioethics, with a circulation of 90,000.

MEDIA ALERTS ARE AVAILABLE.  CONTACT media@bioethics.net TO SIGN UP.

Each issue of AJOB publishes several target articles on current controversial issues in bioethics along with open peer commentaries on the subject. Recent feature articles in the journal addressed therapeutic cloning, gifts to doctors, fertility treatments for people infected with HIV, insurers’ decisions about which medical treatments will be covered, and sham surgery.

A free copy of the journal can be obtained from the Taylor and Francis website at http://www.tandf.co.uk/journals/titles/15265165.asp or at http://bioethics.net.  The website provides access to the latest news in bioethics, free feature articles from the journal, as well as links to jobs in the field, events of interest, and the bioethics bookstore.

Daily Pennsylvanian Article

Annual Council of Editors of Learned Journals Awards Competition recognizes outstanding achievement in scholarly journal publications

(San Diego, CA) — Calling it ” …the equivalent of Nature for the field of bioethics, in that it covers critical issues from a wide range of biomedical sciences and is cited frequently in the peer-reviewed literature,” the Council of Editors of Learned Journals (CELJ) selected the American Journal of Bioethics (AJOB), based in the Department of Medical Ethics at the University of Pennsylvania School of Medicine and published by MIT Press, as ‘Best New Journal’ for 2003. This prestigious award, which was announced at CEIJ’s annual meeting in San Diego this week, was awarded to AJOB from among more than 200 entries submitted by more than 50 presses, as the most outstanding new journal by its peer jury.

AJOBwas singled out for its technological and scholarly innovation. It is the first journal ever reviewed, according to CELJ reviewers, which involves ‘a level of interdisciplinary interaction in the production of a paper and online journal.’ TheJournalwas also praised for its strong policy on conflict of interest, which one reviewer termed “… the strongest I have ever seen – stronger than anything suggested by any panel … .” Journal Editor-in-ChiefGlenn McGee, PhD,explains, “Under AJOB’s policy, editorial conflicts of interest as well as peer reviewer conflicts of interest, including mandatory disclosure of all sources of income by all members of the editorial staff, are regularly subject to review.” McGee, who is an Assistant Professor in Penn’s Department of Medical Ethics continues, “In addition, the Journal maintains its conflict of interest disclosure policy on both the MIT and Penn AJOB websites.”

According to CELJ award guidelines, the selected new journal must be in publication no more than five years. Entries are submitted in dozens of disciplines and areas of study by scholarly presses which are members or whose editors are elected members of CELJ.

The American Journal of Bioethics is the first journal edited at Penn to win this award.The editorial offices of The American Journal of Bioethics have been based at Penn’s Center for Bioethics since the founding of the Journal in 2001 by McGee and associate editor David Magnus, PhD, formerly of Penn and now of Stanford University. Master of Bioethics student Kelly Carroll is Executive Managing Editor of the Journal. Electronic Media Editor is John Kwon (MSE ’00). Book Review Editor is Mark Aulisio, PhD, of Case Western Reserve University School of Medicine, and Special Features Editor is Paul Root Wolpe, PhD, also of Penn.