Bilateral hand transplantation: supporting the patient’s choice

• Published in: Journal of plastic, reconstructive & aesthetic surgery Vol. 70; no. 2; pp. 147 - 151
• Main Authors: Dumont, M., B.A, Sann, L., M.D, Gazarian, A., M.D
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.02.2017
• Subjects: Autonomy; Decision Making; Ethics; Hand transplantation; Hand Transplantation - ethics; Humanities and Social Sciences; Humans; Informed Consent; Life Sciences; Patient Selection - ethics; Personal Autonomy; Philosophy; Physician-Patient Relations - ethics; Plastic Surgery; Decision-making; Ethics; Informed consent; Autonomy; Hand transplantation
• ISSN: 1748-6815; 1878-0539; 1878-0539
• DOI: 10.1016/j.bjps.2016.11.010

Abstract Bilateral hand transplantation, as a fairly new reconstructive option for amputees, raises major ethics questions. This article, based on reflections arising from the rich experience of the Lyon's team in this field, adresses the topic of supporting the patient in his choice for or against this procedure. How should autonomy be understood in this particular setting? The developing field of composite tissue allotransplantation needs to establish a common thinking on that subject. The article emphasizes that, even if it is their right to decide, patients have to be carefully supported to help them make the most consolidated choice possible in this challenging procedure. We deal with the questions of the choice under uncertainty in these innovative procedure and of the choice of a life-threatening treatment to alleviate a handicap. We outline that the whole process of hand allograft is a unique opportunity for the patients to strenghten and exercise their autonomy, in interaction with the medical team.