I know I name drop Arthur Caplan’s name quite a bit. Yet, he really nails many ethical issues on the head. I’ve been reading quite a bit on transplant advances & new forms of transplants being done lately. It’s exciting to me on one hand, on the other it deeply conflicts me…
I think his recent Forbes piece is very balanced. I’d been seeing all the news regarding the most extensive face transplant done to date, the new up & coming uterine transplants for women. (This in addition to the firsts in new transplant combinations, such as heart-kidney & kidney-bowel transplants).
Yet, I remained unsettled about it for some of these cases. Even others I know I’m not mentioning that are still purely experimental. I’m all for scientific advancement yet something wasn’t sitting right with me as I first read these articles. I couldn’t figure out exactly what. Until now. When I read what Dr. Caplan had to say, it resonated deeply & expressed many thoughts I had held back or couldn’t quite articulate.
I know some of these elective forms of transplant enhance quality of life for those people as much or more than my future lung transplant will for me.
That said, having taken an immunosuppressant drug for over 5 years now, it is not something I would willingly recommend to someone as an elective option in most cases or even as a general rule.
Overall, I’ve stayed in relatively decent health in spite of the immunosuppression, but I’ve had my share of struggles with it from time-to-time. For me; however, the benefits outweighed the risk. I was unlikely to be worse off from taking the gamble. I had to do something to slow the advance of my illnesses. There was no other option, I was certainly no worse for trying. Even if it hadn’t have worked or I had a reaction, I would not have been any worse off for having made the attempt. At that point, doing nothing would have made oxygen & transplant a reality much sooner. Advances & statistics as far as survival were not near what they were 5 years ago, in comparison to what they are now. That treatment bought me precious & necessary time in addition to enhancing my quality of life.
I guess that’s why my lung transplant didn’t seem like that much of a huge leap to me when the time came to face the fact that I finally needed to put it on the table after my treatment stopped holding my lungs. I had already had a taste of what that life was like, albeit to a lesser degree, & not with multiple agents in the mix.
I understand & would never stand in the way of someone deciding what is best for them personally, in any healthcare decision-making situation. It is highly personal.
I do have serious concerns about elective transplantation unless it’s for gross (large part of the body/organ) disfigurement or a last resort. Solely because of the trade-offs that come with it. They are not easy by any stretch.
Other health problems can develop as a result of any transplant. New issues, even (like developing diabetes, for one). Once healthy organs outside those being transplanted may be unduly stressed & pulled down.
Like any option, experimental or otherwise, it requires serious discussion of risks versus potential benefits. Typically in spheres like mine & others with failing organs, we have 3 years or less on average to live when we start transplant evaluation testing.
We typically have no other options available to us. Not taking the leap can be of greater consequence & harm than taking the leap itself.
It is not an easy process for those who choose to undergo it, even when they are prepared & know they have to.
Most people are naive & unaware to the toll it takes on the candidate & their caregiver(s) & supports.
The journey is often fraught with intense emotions that surface as one makes their way through. There is really no way in advance to mentally prepare for this, no matter how the candidate is resigned to & at peace with the fact that transplant is a necessary step.
Transplantation, as a whole, is not the same as removing a troublesome gallbladder or replacing a worn out joint, or other “routine” surgeries. Even these new types of “elective” transplant procedures come with a high cost that most people can’t even begin to fathom or wrap their minds around. Unless they’ve seen someone venture down that path previously in a “non-elective” situation in order to keep going.