The Ethics of Penis Transplantation: A Systematic Review
Location
Philadelphia, PA
Start Date
8-5-2019 1:00 PM
End Date
8-5-2019 4:00 PM
Description
Purpose: We conducted this systematic review to document ethical concerns regarding human penis allotransplantation and how these concerns have changed over time.
Methods: We searched six databases (MEDLINE via PubMed, Embase, CINAHL, Scopus, Web of Science, and Google Scholar) from inception to November 9, 2018 to find articles addressing ethical concerns related to penis allotransplantation. Inclusion criteria were articles written in English on the topic of penis allotransplantation that discussed at least one bioethical principle. Data was extracted and categorized into the four bioethical pillars: autonomy, beneficence, nonmaleficence, and justice. We assessed theme frequency by publication year and temporal trends. A sub-analysis of the Bioethical pillars and themes specifically addressing the first penis transplantation case performed in 2006 were extracted and evaluated separately.
Results:Search results yielded 142 citations. Thirty-nine articles were eligible and included in the final data extraction and analysis. Publication years were 2006 through 2018 with an average of 3 publications per year (range: 0 to 12). The most frequently addressed bioethical pillar was nonmaleficence with themes included in 37 of 39 articles (95%), followed by beneficence (36 of 39, 92%), justice (32 of 39, 82%), and autonomy (29 of 39, 74%). Top concerns pertaining to nonmaleficence included the risk-benefit ratio (n=30, 81%) and risks of long-term immunosuppression (n=29, 78%). Top concerns regarding beneficence included restoration of bodily function, integrity, or aesthetics (n=33, 92) and improved QOL (n=25, 69%). Top concerns pertaining to justice included patient selection (n=25, 78%), burden to donor family, and impact on deceased donor solid organ donation (n=13, 41%). Top concerns regarding autonomy included patient informed consent (n=18, 62%), and donor or donor family informed consent (n=16, 55%). Bioethical issues in reference to the 2006 case were mentioned in 29 of 39 articles (74%); nonmaleficence was most often addressed, mentioned in 27 of 29 articles (93%).
Conclusions: Penis transplantation has been a topic of much ethical debate. During the 12-year study period, nonmaleficence was the most common recurring ethical pillar with the two most common themes being risks and benefits for undergoing the procedure and the need for life-long immunosuppression. The first attempt in 2006 that resulted in the graft being removed greatly influenced the field of penis transplantation.
Embargo Period
5-28-2019
The Ethics of Penis Transplantation: A Systematic Review
Philadelphia, PA
Purpose: We conducted this systematic review to document ethical concerns regarding human penis allotransplantation and how these concerns have changed over time.
Methods: We searched six databases (MEDLINE via PubMed, Embase, CINAHL, Scopus, Web of Science, and Google Scholar) from inception to November 9, 2018 to find articles addressing ethical concerns related to penis allotransplantation. Inclusion criteria were articles written in English on the topic of penis allotransplantation that discussed at least one bioethical principle. Data was extracted and categorized into the four bioethical pillars: autonomy, beneficence, nonmaleficence, and justice. We assessed theme frequency by publication year and temporal trends. A sub-analysis of the Bioethical pillars and themes specifically addressing the first penis transplantation case performed in 2006 were extracted and evaluated separately.
Results:Search results yielded 142 citations. Thirty-nine articles were eligible and included in the final data extraction and analysis. Publication years were 2006 through 2018 with an average of 3 publications per year (range: 0 to 12). The most frequently addressed bioethical pillar was nonmaleficence with themes included in 37 of 39 articles (95%), followed by beneficence (36 of 39, 92%), justice (32 of 39, 82%), and autonomy (29 of 39, 74%). Top concerns pertaining to nonmaleficence included the risk-benefit ratio (n=30, 81%) and risks of long-term immunosuppression (n=29, 78%). Top concerns regarding beneficence included restoration of bodily function, integrity, or aesthetics (n=33, 92) and improved QOL (n=25, 69%). Top concerns pertaining to justice included patient selection (n=25, 78%), burden to donor family, and impact on deceased donor solid organ donation (n=13, 41%). Top concerns regarding autonomy included patient informed consent (n=18, 62%), and donor or donor family informed consent (n=16, 55%). Bioethical issues in reference to the 2006 case were mentioned in 29 of 39 articles (74%); nonmaleficence was most often addressed, mentioned in 27 of 29 articles (93%).
Conclusions: Penis transplantation has been a topic of much ethical debate. During the 12-year study period, nonmaleficence was the most common recurring ethical pillar with the two most common themes being risks and benefits for undergoing the procedure and the need for life-long immunosuppression. The first attempt in 2006 that resulted in the graft being removed greatly influenced the field of penis transplantation.