Academic journal article The Hastings Center Report

Wearing Your Organ Transplant on Your Sleeve

Academic journal article The Hastings Center Report

Wearing Your Organ Transplant on Your Sleeve

Article excerpt

There have now been two attempts, one in France and one in the United States, to transplant a human hand. Both have attracted attention, but neither has received real scrutiny. While the American team tried to engage some of the issues raised by such surgery before undertaking their experiment, the French experiment was conducted with no advance notice or discussion.

More discussion is certainly warranted. This pioneering form of surgery raises a host of new ethical and policy questions. First, how much risk is to be tolerated in the name of quality of life? The drugs used to control the rejection of a transplant have life-threatening side effects. Such risks are normally accepted in transplant surgery because of the fatal consequences of organ failure. But the risk-benefit equation is far more problematic when the purpose of a transplant is only to improve the quality of life. Further, for single-hand amputees, such as the subjects of the two recent experiments, artificial limbs can provide useful function. While it would be a remarkable scientific achievement to successfully graft a hand from a dead human being to a living one, the experiment seems justifiable only for persons who have lost both hands.

The fact that limb transplantation is aimed at improving quality of life raises another new and especially vexing moral issue: who is to define success or failure of the surgery? When a heart or liver is transplanted it is clear what failure is. But in the transplantation of a hand the subject may feel that the surgery has not gone well long before the surgical team does. …

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