The sacred and the profane: biotechnology, rationality, and public debate

Davies G, 2006. The definitive, peer-reviewed and edited version of this article is published in Environment and Planning A, 38(3), pp. 423 – 443 DOI: 10.1068/a37387This paper explores the forms of argumentation employed by participants in a recent public engagement process in the United Kingdom around new technologies for organ transplantation, with specific reference to xenotransplantation and stem-cell research. Two forms of reasoning recur throughout participants’ deliberations which challenge specialist framing of this issue. First, an often scatological humour and sense of the profane are evident in the ways in which participants discuss the bodily transformations that such technologies demand. Second, a sense of the sacred, in which new biotechnologies are viewed as against nature or in which commercial companies are ‘playing god’, is a repetitive and well-recognised concern. Such forms of reasoning are frequently dismissed by policymakers as ‘uninformed gut reactions’. Yet they also form a significant part of the repertoire of scientists themselves as they proclaim the hope of new medical breakthroughs, or seek to reconstruct ideas of the body to facilitate new biotechnological transformations. Through questioning of assumptions in Habermas’s notion of discourse ethics, and exploring the importance of hybridity and corporeality as concepts in ethical thinking, the author suggests that, far from being ill-formed opinions, such reasonings perform an important function for thinking through the ontological significance of the corporealisation of these proposed new forms of human and animal bodies

Gaining face or losing face? Framing the debate on face transplants

An American surgical team has announced its intention to perform the first human facial transplantation. The team has, however, invited further analysis of the ethical issues before it proceeds and in this paper we take up that challenge in seeking to frame the debate with a particular focus on the recipients of the transplant. We address seven related areas of concern and identify numerous questions that require answers or, perhaps, better answers. We start by examining the nature of the procedure and its intended benefits, why the procedure is being developed, and whether or not this should be viewed as experimental. Having concluded that this is experimental in nature, we then consider the broad question, who is the patient? Here we perceive difficulties in terms of the autonomy of the recipient, the unpredictable effects of receiving the transplant, and the role and influence of society. We conclude by asking whether the question should be 'whether or not?' rather than 'when?', particularly while the risks of losing face appear to far outweigh the likelihood of gaining face. © Blackwell Publishing Ltd. 2005

A qualitative analysis of attitudes to face transplants: contrasting views of the general public and medical professionals

While there has been a considerable criticism and debate about face transplantation from ethicists, surgeons and psychologists, little is known about the attitudes of medical professionals and the general public whose support will be necessary if face transplants are to be accepted. This study therefore conducted in-depth, semi-structured interviews with medical professionals (8) and the general public (8) to explore their understanding of and attitudes to face transplants. A thematic analysis was used to analyse these data. Five overarching themes were identified including agreement in principal, caveats and conditions, medical and technical difficulties, function and appearance, and the significance of the human face. The analysis revealed overwhelming support in principle for face transplants, but with important caveats and conditions. Both groups shared clear representations of deserving and undeserving candidates, and concerns about psychological adjustment. The general public sample demonstrated little understanding of medical implications or the consequences of a failed graft, which did concern the medical professionals. Neither group showed a clear understanding of the psychological or social factors required to predict best outcomes and identify suitable candidates. Analyses revealed a stereotypical belief from both groups that the life of a severely disfigured recipient is intolerable without this operation