Citation

McQuinn MW, Kimberly LL, Parent B, Diaz-Siso JR, Caplan AL, Blitz AG, Rodriguez ED. Camb. Q. Healthc. Ethics 2019; 28(3): 450-462.

Copyright

(Copyright © 2019, Cambridge University Press)

DOI

10.1017/S0963180119000379

PMID

31298191

Abstract

Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of considering mechanism of injury in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation.

Language: en

Keywords

facial transplantation; patient selection; self-inflicted gunshot wound; transplant outcomes