Hand Transplant UK, Leeds Teaching Hospitals Trust, Leeds, UK.
School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, UK.
J Hand Surg Eur Vol. 2023 Mar;48(3):208-213. doi: 10.1177/17531934221132665. Epub 2023 Jan 13.
Asking 'can we balance the risks and benefits?' implies that a quantification of both risk and benefit in hand transplantation (here the terms hand transplant and hand transplantation refer to allotransplantation of the human hand or hand and part or all of the upper limb or limbs) is possible. Despite all we have learned in recent years about hand transplantation, much remains unknown. Even if reliable methods for quantification of risk and benefit were available, fundamental issues relating to effective communication across the gulf of lived experience between the (presumably) handed surgeon and the handless patient remain. Inherent complexities mean some consider hand transplantation an unsolved problem, but we believe the medical and technical considerations fall within the ambit of a competent multidisciplinary team, and that psychosocial and ethical challenges are open to management through robust frameworks for assessment and decision making, underpinned by an extended period of assessment and dialogue, with candid acknowledgement where uncertainty remains. This respects the patient's autonomy while addressing the need for a prolonged period of informing consent. V.
询问“我们能否平衡风险和收益？”意味着对手移植（这里的术语“手移植”是指异体手部或手部及部分或全部上肢或肢体的移植）中的风险和收益进行量化是可能的。尽管近年来我们对手移植有了更多的了解，但仍有许多未知。即使有可靠的风险和收益量化方法，如果要跨越有手的外科医生和无手的患者之间的实际经验鸿沟进行有效的沟通，仍然存在一些基本问题。由于其内在的复杂性，一些人认为手移植是一个尚未解决的问题，但我们认为医疗和技术方面的考虑属于有能力的多学科团队的范畴，并且通过评估和决策的强大框架来管理社会心理和伦理方面的挑战，这是可行的，该框架以延长评估和对话周期为支撑，对不确定性持坦率承认的态度。这既尊重了患者的自主权，又满足了告知同意的长期需求。V。
