| The bioethics of separating conjoined twins in plastic surgery. | |
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MedLine Citation:
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PMID: 21921746 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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SUMMARY:: The incidence of craniopagus twins approximates four to six per 10 million births. Although rare, surgical separation of conjoined twins poses significant technical and ethical challenges. The present report uses the case of craniopagus twins AD and TD to examine the bioethical issues faced by a multidisciplinary medical team in planning the separation of craniopagus twins. AD and TD are craniopagus twins conjoined at the head. TD's head is conjoined to the back of AD's head. Neurologically, AD has the dominant cerebral circulation. TD has two normal kidneys, whereas AD has none. AD depends on TD's renal function and, on separation, will require either a kidney transplant or lifelong dialysis. This case report reviews one approach to analyzing and solving complex ethical dilemmas in pediatric plastic surgery. The principles reviewed are (1) autonomy and informed consent, focusing especially on the role of children in the informed consent process; (2) beneficence and nonmaleficence, two intricately intertwined principles because separation could potentially cause irreversible harm to one twin while improving the quality of life for the other (as separation is not a life-saving procedure, is it ethical to perform a procedure with unknown surgical risk to improve children's quality of life?); and (3) justice (is it fair to allocate excessive medical resources for the twins' separation?). The present report explores the ethics behind such decisions with respect to the separation of conjoined twins. |
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Authors:
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Michelle Lee; Arun K Gosain; Devra Becker |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Plastic and reconstructive surgery Volume: 128 ISSN: 1529-4242 ISO Abbreviation: Plast. Reconstr. Surg. Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-09-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1306050 Medline TA: Plast Reconstr Surg Country: United States |
Other Details:
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Languages: eng Pagination: 328e-34e Citation Subset: AIM; IM |
Affiliation:
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Cleveland, Ohio From the Department of Plastic and Reconstructive Surgery, Rainbow Babies and Children's Hospital, University Hospitals Case Medical Center, Case Western Reserve University. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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