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ethics, facial transplantation, innovation, Moore's Framework for the ethical acceptability of surgical innovation, multidisciplinary healthcare team



  1. Evans, Linda A.


Background: Situations that highlight the healthcare team member vulnerability, present ethically laden questions, or are innovative in nature may have a long-term personal and professional impact on caregivers and, consequently, directly or indirectly affect patient care. The ethical experiences and perceptions of the healthcare team members involved in facial transplantation procedures and patient care have not been explored.


Objective: The objective of this study was to explore healthcare team member experiences of caring for facial transplantation patients, using an ethical framework.


Methods: This study used a qualitative descriptive design to explore the experiences of 26 multidisciplinary healthcare team members, including professional, ancillary, and support staff who have participated in facial transplantation procedures and patient care. Individual, private, semistructured interviews were conducted.


Results: Two main themes emerged: individual sense of purpose and esprit de corps. Individual sense of purpose describes the meaning of the experience that involvement in facial transplantation had for the participants and comprises three subthemes: "getting it right, "transforming a life," and "spirituality." The theme esprit de corps conveys the morale of the healthcare team members involved in facial transplantation and was expressed through three subthemes: "leadership," "teamwork," and "environment."


Discussion: Many potential ethical dilemmas were mitigated by an overwhelming sense of moral obligation to help patients with complex cosmetic, functional, and mechanical facial deficits. Participants in this study unanimously believed that the risk-benefit ratio of the procedure and subsequent treatment supported its implementation.