The modifications to this law were made in late 2013 and required the national transplant agency to develop policies for VCA transplant before July 3. The piece of law that governs organ transplantation in the USA is referred to in short as the OPTN Final Rule. From the get go, then, we see that normative sociopolitical concerns have been embroiled in the shifting status of the face for transplantation. In making the face an organ, the Federal government has nationalized face transplantation in two interrelated ways: by standardizing disparate practices and by encoding them with values of what it stood for. Appropriate Federal oversight of a national allocation system can increase safety of such transplants and provides equitable and consistent national access to such transplants while also conveying to the public that donation for such purpose will serve an essential medical need, ( OPTN, Notice of proposed rulemaking).Ĭontained within the above is an implicit understanding of what both VCA procedures and the US state are about: ensuring equitable, safe and essential biomedicine. …ensure equitable access for those awaiting VCA transplantation, there is a need to provide for consistency in allocation processes and reliable outcomes reporting on a nationwide basis. The Federal changes to the definition of an “organ” sought to standardize clinical practice for VCA procedures and, in doing so: Let’s have a look then, at how such shaping is mediated by policy and broader sociopolitical concerns. This echoes Mol’s account of how medicine shapes its objects. The ontological status of the face in this form of medicine is thus both fluid and fractured. It is never just a face and never fully an organ it is only an organ once it is removed from the donor and transplanted to the recipient, at which point it straightaway becomes a face as a VCA the face extends past the immediate area of the face to include veins, nerves and extra tissue that would aid operative outcomes. The changes to national transplant law and the redefinition of an organ to include VCAs mean that the face for transplantation now has a rather peculiar ontological status. In this short post, I want to examine this idea. Are we leaving anything out if we begin our analysis in the present by looking at how the body is experienced and enacted in and through clinical practice? The deliberations of the VCA committee suggest that we should take more notice of the background work that implicitly shapes the clinical space – that we should examine how ontology in medicine is constituted in/by practice and policy. This has made me consider whether something is missing from those hospital-based accounts of ontology and medicine. Recently I have been reading through the minutes of the OPTN VCA Committee, which was established to review agency policy in light of the aforementioned changes to the Federal health law. While it isn’t yet possible to show in detail how the face for transplantation in enacted in light of this policy change, its new status as a VCA organ has been cause for deliberation by the agencies that until now have been responsible for administrating the procurement and allotment of body parts such as the heart, kidney, and liver. One of the most well known examinations of ontology in medicine is Ann Marie Mol’s The Body Multiple (Duke 2003), in which the author masterfully demonstrates how “medicine enacts the objects of its concern and treatment,” that is, how it “attunes to, interacts with, and shapes its objects in its various and varied practices” (vii).

In this post I want to shift focus a little to think about how the ontological status of body parts in technomedicine are shaped vis-à-vis regulatory practice. In my book On Face Transplantation: Life and Ethics in Experimental Biomedicine (Palgrave Macmillan 2014), I argue that what is being remade in face transplantation is not only the lives of patients, but also the very ways in which state institutions, surgeons, and families make sense of rights, claims for inclusion, and life itself in the contemporary world. My research to date has examined how the former has introduced new institutional and epistemic understandings and practices into world of biomedicine.

The most common VCA procedures are face transplantation and hand transplantation. The term refers to vascularized composite allografts, complete sections of tissue that are procured for transplantation.

This policy introduced into the world a new type of thing: the “VCA organ”. Changes to US Federal health policy came into effect, moving face transplantation into the jurisdiction of medical procedures governed and administrated by the agencies that oversee the US national transplant system – the Organ Procurement and Transplant Network (OPTN) and the United Network for Organ Sharing (UNOS). On July 3 of this year, the face became an “organ”.

Facebar by pamela