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Stem Cells International
Volume 2017, Article ID 1286246, 11 pages
https://doi.org/10.1155/2017/1286246
Review Article

Hematopoietic Stem Cell Transplantation: A Bioethical Lens

1Institute of Hematology, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy
2Department of Morphology, Experimental Medicine and Surgery, University of Ferrara, Via Fossato di Mortara 70, 44121 Ferrara, Italy
3Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Ospedale ‘Colonnello D'Avanzo’, Viale Degli Aviatori 1, 71122 Foggia, Italy
4Istituto Clinico-Scientifico Malzoni, 83100 Avellino, Italy
5Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00185 Rome, Italy

Correspondence should be addressed to Emanuela Turillazzi; ti.dniwni@izzallirut_aleuname

Received 11 February 2017; Revised 22 March 2017; Accepted 15 May 2017; Published 27 June 2017

Academic Editor: Gerald A. Colvin

Copyright © 2017 Arcangelo Liso et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hematopoietic stem cell transplantation (HSCT) is one of a range of therapeutic options available to patients suffering from various diseases. HSCT procedure involves important ethical and legal aspects that can occur at every phase of the procedure: the clinical choice of whether to perform the procedure, pretransplantation preparation regimens, donor selection, stem cell harvest procedure, transplantation phase, and short-term and long-term follow-up care. In this discussion paper, we outline the ethical issue-facing physicians involved in HSCT. Currently, HSCT is a widely accepted treatment for many life-threatening diseases. It thus represents a real therapeutic hope for many patients. It does, however, carry a burden of possible morbidity and mortality. Consequently, there are substantial information and communication issues involved in the consent process for HSCT. In the final decision, the judgements of different parties, such as patients, family members, and healthcare professionals, intersect and overlap and this is particularly true when the patient is a minor. Finally, HSCT is a very expensive procedure. The social and economic concerns of HSCT are discussed within the actual contextual framework of the dramatic increase in healthcare costs and inequalities in healthcare in relation to socioeconomic status, educational status, and ethnicity.