Facial Transplants: a Comparative Sociology of a Surgical Innovation in France and the United Kingdom

The first facial transplant took place in France in 2005. This kind of operation is aimed at repairing the face of someone disfigured, and requires an organ donor. In what scientific, political and social context does this surgical innovation emerge? The inquiry follows the development of this technology between 1990 and 2016, in France and in the United Kingdom. The first public debates on facial transplants took place in the U.K. and were held, as of 2000, in a context marked by the enthusiasm of surgeons regarding preparations for a “surgical first” and the heated protests of an association of disfigured persons. In France, experiments on humans began in a climate of controversy between scientists and institutions responsible for research ethics, but in the absence of social protest. At present, U.K. teams have not carried out a transplant project. In France, eleven patients have undergone surgery, three of whom died between a week and ten years after the transplant. This research links the sociology of sciences, the anthropology of personhood, as well as disability studies with the approaches of pragmatic sociology.

The inquiry involved a plurality of observation methods in the milieus involved in projects of facial transplants: ethnography of the hospital services where the operation is performed and surgical congresses where it is discussed, scientific and media archives, interviews with medical professionals, members of health and ethics agencies, associative actors, and the long-term follow-up of persons awaiting or having already undergone transplants. Following the itinerary of the object in each national context, this thesis shows how facial transplants unsettled both the field of organ transplants and that of combats against discrimination based on appearance. The analysis gives insight into the disputes that erupt concerning two main issues. On one hand, can we have recourse to the body of an organ donor for a transplant that for many seems non vital? On the other hand, does a facial transplant give rise to a life-threatening risk because of a social problem, namely that of discrimination against disfigured persons?