TY - JOUR

T1 - Ethical and Policy Issues Raised by Uterus Transplants

AU - O'Donovan, Laura

AU - Williams, Nicola Jane

AU - Wilkinson, Stephen Derek

PY - 2019/9/2

Y1 - 2019/9/2

N2 - Introduction: In 2014, Brännström and colleagues reported the first human live birth following uterine transplantation (UTx). Research into this treatment for absolute uterine factor infertility has since grown with clinical trials currently taking place across centers in at least thirteen countries worldwide.Sources of data: This review summarizes and critiques the academic literature on ethical and policy issues raised by UTx.Areas of agreement: There is general agreement on the importance of risk reduction and, in principle, to the sharing and maintenance of patient data on an international registry.Areas of controversy: There are numerous areas of controversy ranging from whether it is ethically justified to carry out uterus transplants at all (considering the associated health risks) to how deceased donor organs for transplant should be allocated. This review focuses on three key issues: the choice between deceased and living donors, ensuring valid consent to the procedure and access to treatment.Growing points; UTx is presently a novel and rare procedure but is likely to become more commonplace in the foreseeable future, given the large number of surgical teams working on it worldwide.Areas timely for developing research: Uterus transplantation requires us to re-examine fundamental questions about the ethical and social value of gestation. If eventually extended to transgender women or even to men, it may also require us to reconceptualize what it is to be a ‘father’ or to be a ‘mother’, and the definition of these terms in law.

AB - Introduction: In 2014, Brännström and colleagues reported the first human live birth following uterine transplantation (UTx). Research into this treatment for absolute uterine factor infertility has since grown with clinical trials currently taking place across centers in at least thirteen countries worldwide.Sources of data: This review summarizes and critiques the academic literature on ethical and policy issues raised by UTx.Areas of agreement: There is general agreement on the importance of risk reduction and, in principle, to the sharing and maintenance of patient data on an international registry.Areas of controversy: There are numerous areas of controversy ranging from whether it is ethically justified to carry out uterus transplants at all (considering the associated health risks) to how deceased donor organs for transplant should be allocated. This review focuses on three key issues: the choice between deceased and living donors, ensuring valid consent to the procedure and access to treatment.Growing points; UTx is presently a novel and rare procedure but is likely to become more commonplace in the foreseeable future, given the large number of surgical teams working on it worldwide.Areas timely for developing research: Uterus transplantation requires us to re-examine fundamental questions about the ethical and social value of gestation. If eventually extended to transgender women or even to men, it may also require us to reconceptualize what it is to be a ‘father’ or to be a ‘mother’, and the definition of these terms in law.

KW - Access to health care

KW - AUFI

KW - consent

KW - Donation

KW - Ethics

KW - healthcare access

KW - infertility

KW - Reproduction

KW - transplantation

KW - Uterine Transplants

KW - Uterus Transplantation

KW - Uterine Diseases

KW - Infertility Treatment

KW - Infertility, Female

KW - Healthcare Expenditure

KW - healthcare

KW - Transplantation Ethics

U2 - 10.1093/bmb/ldz022

DO - 10.1093/bmb/ldz022

M3 - Journal article

VL - 131

SP - 19

EP - 28

JO - British Medical Bulletin

JF - British Medical Bulletin

SN - 0007-1420

IS - 1

ER -