Ethics of Penile Transplants

by Craig Klugman, Ph.D.

This weekend, doctors in South Africa announced a new first—a successful penis transplant. The 9-hour operation took place in December 2014. After three months of recovery, the recipient is able to urinate, achieve an erection and a sexual response. As of yet, the recipient does not have full sensation in the organ.

The recipient was 18 years old when he underwent a ritual circumcision that went wrong and left him with 1cm of the original penis. Estimates are that dozens to hundreds of men are maimed each year as a result of these rituals.

This was not the first attempted transplant. That honor goes to China in 2006. The patient had the penis removed after he and his wife described psychological distress and strange swelling.

A BBC report said that the South African surgeons spent time asking whether this operation was ethical. After all, the recipient will be on anti-rejection drugs for the rest of his life and a penis may be psychologically and reproductively important, but it is not life supporting in the way that a heart or liver would be. Using needle aspiration and in vitro fertilization, these men could father children. Alternative methods can be fashioned to allow the elimination of urine. Sexual function though, is clearly compromised.

A 2010 article in the Asian Journal of Andrology discussed the ethical issues of penile transplant. These included surgical risks, informed consent, body image, and privacy. For the donor family, the authors identified concerns with assessing the suitability of a donor, privacy, and the consent process.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.