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16.
In the ethical discussion on
xenotransplantation, the subject of informed consent also deserves special
attention.(70)
Given the animal source
of the organs which will be transplanted, this issues concerns only the
recipient and, secondly, his relatives. At the outset the recipient should be
given every information regarding his pathology and its prognosis, the
xenotransplant operation and subsequent therapy, and the probability of success
and the risks of rejection. Special attention should be paid to making sure
that the patient is informed about the real and hypothetical risks of zoonoses,
in light of current data, and about the precautions to be adopted in the case
of infection (in particular the possible need for quarantine, which involves
avoiding physical contact with others while the risk of contagion is present).
The patient must also be informed about the need to remain under medical
supervision for the rest of his life, so that the necessary constant monitoring
following the transplant may be carried out. In addition, adequate information
on possible alternative therapies to xenotransplant therapy should not be
withheld.
This informed consent on
the part of the patient should be understood as personal. For this
reason, minors and those unable to give valid consent are to be excluded from
the experimental phase.
However, if a patient
incapable of giving valid consent should find himself in a previously
unforeseen situation where there is danger of imminent death, recourse may be
made to a legal representative (e.g. in the hypothetical case of a life-saving
xenotransplant as a temporary solution for a patient in a coma), provided that
the medical procedures to be used offers a reasonable hope of benefit for the
patient.
The patient's relatives
should also be informed about what the transplant could entail regarding their
contact with the patient and about the possible risks of contagion should an infection,
as mentioned above, set in. In a strict sense, however, consent cannot be
requested from them, since it is the patient who is ultimately responsible for
the choices concerning his own health.
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