Face transplants quite obviously complicate such transactions. A face transplant implicates continuation of the deceased in a way that an internal organ or tissue transplant does not. Because the face is so tied up with the deceased’s personal identity, the idea of transplanting his or her face will be a highly charged one. In many cases the family is likely to think of their loved one in terms of their face. The connection between face and the deceased might be so unique that a family otherwise willing to donate organs will recoil at the idea of donating the deceased’s face. Given this risk, it is especially important that donors give explicit consent to face donations and not have them occur as part of a generalized consent to donation of tissue and organs. Special counseling of donors and donor families may be necessary to accomplish this. Also, face donations may be too complicated to be considered in cases of sudden death (uncontrolled non–heart beating donors) where there is little time to explore these issues.

On the other hand, some donor families might welcome donation of the deceased’s face as a continuation of that person, thus fostering the misperception that the deceased is still alive when he or she is dead. But, they are likely to be barred from any information about or contact with the recipient, and may suffer frustration and further anguish as a result.