Defining Success and Ethical Decision-Making in Vascularized Composite Allotransplantation: A Bioethical Deliberation Model

Abstract

This chapter explores the intricate bioethical considerations surrounding Vascularized Composite Allotransplantation (VCA) and proposes a bioethical deliberation model. The primary focus is on defining success criteria for VCA and fostering ethical decision-making to enhance patient outcomes. The chapter delves into critical variables to define beneficence, non-maleficence, autonomy, and justice and their role in shaping the success of VCA procedures. The significance of assessing both receiver and institutional capacities is emphasized, along with the importance of objective resilience, deferential vulnerability, and decisional capacity in evaluating patient eligibility. Furthermore, the healthcare team’s capacity for ethical deliberation and the resources required to support patient resilience are explored. By addressing these crucial factors, the proposed bioethical deliberation model aims to align VCA practices with the principles of beneficence, non-maleficence, autonomy, and justice. This chapter offers valuable insights into the ethical dimensions of VCA and provides a framework that can contribute to improved patient care and treatment outcomes.