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Ethical Issues in Pediatric Vascularized Composite Allotransplantation

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Ethical Issues in Pediatric Organ Transplantation

Part of the book series: International Library of Ethics, Law, and the New Medicine ((LIME,volume 66))

Abstract

Vascularized Composite Allotransplantation (VCA) enables improved function and quality of life for those who have lost anatomical parts such as a limb and the relief of profound suffering for those with severe facial disfiguration. VCA differs from vital organ transplantation in two important ways: (1) these transplants are not necessary for recipient survival, impacting risk-benefit ratios; and (2) face and limb transplants are visible and touchable, leading to issues of identity changes, social interaction and psychological adjustments. This chapter will consider the ethical implications of VCA in pediatrics. This chapter will be divided into the following six sections: (1) introduction; (2) the state of the science and experience with VCA; (3) risk-benefit assessment; (4) informed consent (i) donors and donor surrogate decision makers (ii) recipients and recipient surrogate decision makers; (5) establishing a pediatric program (i) recipient selection (ii) allocation; (iii) accountability for surgical innovation and (6) conclusion.

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Author information

Authors and Affiliations

  1. Department of Bioethics, The Hospital for Sick Children, Toronto, Canada

    Randi Zlotnik Shaul

  2. Department of Paediatrics, University of Toronto, Toronto, Canada

    Randi Zlotnik Shaul

  3. Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada

    Gregory H. Borschel

  4. Department of Surgery, University of Toronto, Toronto, Canada

    Gregory H. Borschel

  5. Faculty of Medicine, Memorial University, St. John’s, Canada

    Jennifer Flynn

  6. Department of Psychiatry, The Hospital for Sick Children, Toronto, Canada

    Mark D. Hanson

  7. Faculty of Medicine, University of Toronto, Toronto, Canada

    Mark D. Hanson

  8. Department of Surgery, University of Toronto, Toronto, Canada

    Linda Wright

  9. The Division of Plastic and Reconstructive Surgery, The Hospital for Sick Children, Toronto, Canada

    Ronald M. Zuker

  10. Department of Surgery, University of Toronto, Toronto, Canada

    Ronald M. Zuker

Authors
  1. Randi Zlotnik Shaul
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  2. Gregory H. Borschel
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  3. Jennifer Flynn
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  4. Mark D. Hanson
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  5. Linda Wright
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  6. Ronald M. Zuker
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Corresponding author

Correspondence to Randi Zlotnik Shaul .

Editor information

Editors and Affiliations

  1. Department of Family and, The Hospital for Sick Children, Toronto, Canada

    Rebecca A. Greenberg

  2. Dept. of Pediatrics, Winnipeg Regional Health Authority, Winnipeg, Canada

    Aviva M. Goldberg

  3. Department of Philosophy I, University of Granada, Madrid, Spain

    David Rodríguez-Arias

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Shaul, R.Z., Borschel, G.H., Flynn, J., Hanson, M.D., Wright, L., Zuker, R.M. (2016). Ethical Issues in Pediatric Vascularized Composite Allotransplantation. In: Greenberg, R., Goldberg, A., Rodríguez-Arias, D. (eds) Ethical Issues in Pediatric Organ Transplantation. International Library of Ethics, Law, and the New Medicine, vol 66. Springer, Cham. https://doi.org/10.1007/978-3-319-29185-7_10

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