New York, Oct. 12: This year is the 50th anniversary of the first successful human organ transplant. Over the last half-century, the improved understanding of how to prevent the body?s immune system from rejecting foreign tissue has turned what began as an experiment into a routine procedure.

Now we are confronting the imminent possibility that human faces will be transplanted. This month in The American Journal of Bioethics, a team of transplant surgeons at the University of Louisville announced their intention to pursue the transplantation of faces. Last year, a task force at the Royal College of Surgeons of England cautioned against them.

The British group concluded that ?until there is further research and the prospect of better control of complications, it would be unwise to proceed with human facial transplantation,? a procedure that requires review board approval.

The Louisville transplant team, on the other hand, led by Dr. John Barker, argued that caution was a form of dawdling. As he told New Scientist magazine: ?Caution by itself will not get us any closer. If Christopher Columbus were cautious, I?d probably be speaking with a British accent.?

Still, we should be wary of crossing certain frontiers. We now have the ability to excise a face, including nose cartilage, nerves and muscle, from a brain-dead body and suture it to the hairline and jaw of a living person with a disfigured face.

Such a procedure repels and fascinates in equal measure. The face is not like other organs. It twitches, smiles, pouts and squints. It is how we express ourselves to others, and how others recognise us as who we are.

But as grotesque as placing one face over another may seem, surgeons and ethics review boards must confront more than just the ?yuck factor? before they enter an international face race, with at least five teams working toward the first face transplant.

The lack of empirical evidence or long-term studies on face transplantation means that obtaining informed consent for this experimental procedure is highly unlikely. And even if consent is given, where will face donors come from?

Dr. Barker argues that caution hinders surgical advancement. But what is more important: winning the face race? Or upholding the principle of ?do no harm,? as the British team suggests?