PT  - JOURNAL ARTICLE
AU  - Laura L Kimberly
AU  - Elie P Ramly
AU  - Allyson R Alfonso
AU  - Gustave K Diep
AU  - Zoe P Berman
AU  - Eduardo D Rodriguez
TI  - Equity in access to facial transplantation
AID  - 10.1136/medethics-2020-106129
DP  - 2020 Oct 15
TA  - Journal of Medical Ethics
PG  - medethics-2020-106129
4099  - http://jme.bmj.com/content/early/2020/10/15/medethics-2020-106129.short
4100  - http://jme.bmj.com/content/early/2020/10/15/medethics-2020-106129.full
AB  - We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature.