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Self-Inflicted Gunshot Wound as a Consideration in the Patient Selection Process for Facial Transplantation

Published online by Cambridge University Press:  12 July 2019

MICHELLE W. MCQUINN ,
LAURA L. KIMBERLY ,
BRENDAN PARENT ,
J. RODRIGO DIAZ-SISO ,
ARTHUR L. CAPLAN ,
AILEEN G. BLITZ  and
EDUARDO D. RODRIGUEZ
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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.

Keywords

facial transplantationself-inflicted gunshot woundpatient selectiontransplant outcomes
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Issue 3 , July 2019 , pp. 450 - 462
Copyright
Copyright © Cambridge University Press 2019 

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References

Notes

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