Bioethics Blogs

A Matter of Ethics and Policy in the Era of Regenerative Transplantation in the United States

by Macey L. Henderson and Brianna L Doby

Why do we need to care about the ethical development of health policies that impact research, donation, and transplantation in the United States? The story of Zion Harvey is a good place to start.

Zion lost all of his limbs to amputation from sepsis at the age of two. The infection that ravished his body and took his limbs also caused renal failure, resulting in a successful kidney transplant when he was 4 years old. Like all transplant recipients, Zion must take anti-rejection medications for life, making him a good candidate for hand transplantation. Previously, the ethics of transplanting a child with donor hands instead of fitting them with prosthetics was centered around post-transplant medication harms. In July of 2015, Zion became the first pediatric double hand transplant recipient in a landmark 11 hour operation which took place at the esteemed Children’s Hospital of Philadelphia.

Trauma, birth defects, bone or soft tissue malignancies, and other systemic diseases like diabetes can cause disability and sadly, loss of limbs. Amputations create both physical and psychosocial impacts that can be difficult for an individual in regards to day to day functioning, not to mention the aesthetic challenges posed by living in the world without limbs. Prosthetics are a phenomenal advance in biotechnology allowing for both occupational and psychological improvements for patients, but they don’t mimic the sensations or intricate actions that a human hand does.

Until now, candidacy for hand transplantation has been limited to adults. Why? There are vast complexities associated with hand transplantation.

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.