Decision-making for patients with traumatically amputated digits: an ethical analysis
10.3760/cma.j.cn441206-20241021-00225
- VernacularTitle:断指患者医疗决策的伦理探析
- Author:
Shunan DONG
1
;
Lin LI
Author Information
1. 北京积水潭医院贵州医院上肢修复重建外科,贵阳 550014
- Publication Type:Journal Article
- Keywords:
Finger replantation;
Medical decision-making;
Health communication;
Ethics
- From:
Chinese Journal of Microsurgery
2025;48(4):476-480
- CountryChina
- Language:Chinese
-
Abstract:
Replantation surgery for traumatically amputated digits involves reconnection of a severed digit with microsurgical techniques. It has evolved over half a century into a matured medical technique. However, a significant number of patients who are eligible for replantation upon arrival of the hospital do not wish to take the replantation surgery, instead, they opt for stump revision surgery. From July 2024 to August 2024, 320 patients with severed digits and indications for replantation, who were treated in a Tier-IIIA hospital in Southwest China from June 2020 to December 2023, were randomly selected by the Department of Upper Limb Repair and Reconstruction Surgery of Beijing Jishuitan Hospital, Guizhou Hospital. The medical records about surgical plans and outcomes of surgery were statistically analysed retrospectively. At the same time, interviews were conducted with five attending surgeons in the Department of Hand Surgery of the hospital. This article analyses the underlying reasons behind this phenomenon from a medical ethics perspective, and examines the standpoints of the patient and surgeon. This article also explores the ideal model for medical decision-making in digital replantation, and proposes improvements from various aspects. The aim of it is to enable the patients with traumatically amputated digits to make the most appropriate decisions without interference, thereby to minimise the impairment.