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Self-Inflicted Gunshot Wound as a Consideration in the Patient Selection Process for Facial Transplantation

Published online by Cambridge University Press:  12 July 2019

MICHELLE W. MCQUINN ,
LAURA L. KIMBERLY ,
BRENDAN PARENT ,
J. RODRIGO DIAZ-SISO ,
ARTHUR L. CAPLAN ,
AILEEN G. BLITZ  and
EDUARDO D. RODRIGUEZ
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Abstract:

Facial transplantation is emerging as a therapeutic option for self-inflicted gunshot wounds. The self-inflicted nature of this injury raises questions about the appropriate role of self-harm in determining patient eligibility. Potential candidates for facial transplantation undergo extensive psychosocial screening. The presence of a self-inflicted gunshot wound warrants special attention to ensure that a patient is prepared to undergo a demanding procedure that poses significant risk, as well as stringent lifelong management. Herein, we explore the ethics of considering mechanism of injury in the patient selection process, referring to the precedent set forth in solid organ transplantation. We also consider the available evidence regarding outcomes of individuals transplanted for self-inflicted mechanisms of injury in both solid organ and facial transplantation. We conclude that while the presence of a self-inflicted gunshot wound is significant in the overall evaluation of the candidate, it does not on its own warrant exclusion from consideration for a facial transplantation.

Keywords

facial transplantationself-inflicted gunshot woundpatient selectiontransplant outcomes
Type
Articles
Information
Cambridge Quarterly of Healthcare Ethics , Volume 28 , Issue 3 , July 2019 , pp. 450 - 462
Copyright
Copyright © Cambridge University Press 2019 

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References

Notes

1. Sosin, M, Rodriguez, ED. The face transplantation update: 2016. Plastic and Reconstructive Surgery 2016;137(6):1841–50.CrossRefGoogle ScholarPubMed

2. Chicago Tribune. After twin tragedies, man gets face transplant at Mayo Clinic [Internet]. S, Cohen, author. [cited 23 Aug 2017]; available at http://www.chicagotribune.com/lifestyles/health/ct-mayo-clinic-face-transplant-20170217-story.html (last accessed 16 Dec 2018).Google Scholar

3. Chicago, Tribune. Woman receives face transplant after being disfigured by gunshot wound [Internet]. CR, Wootson Jr., author. [cited 23 Aug 2017]; available at http://www.chicagotribune.com/lifestyles/health/ct-gun-shot-face-transplant-20170720-story.html (last accessed 16 Dec 2018).Google Scholar

4. See note 2, Cohen.

5. Lantieri, L, Grimbert, P, Ortonne, N, Suberbielle, C, Bories, D, Gil-Vernet, S, et al. Face transplant: Long-term follow-up and results of a prospective open study. The Lancet 2016;388(10052):1398–407.CrossRefGoogle ScholarPubMed

6. Kiwanuka, H, Aycart, MA, Gitlin, DF, Devine, E, Perry, BJ, Win, TS, et al. The role of face transplantation in the self-inflicted gunshot wound. Journal of Plastic, Reconstructive & Aesthetic Surgery 2016;69(12):1636–47.CrossRefGoogle ScholarPubMed

7. Lassus, P, Lindford, A, Vuola, J, Bäck, L, Suominen, S, Mesimäki, K, et al. The Helsinki Face Transplantation: Surgical aspects and 1-year outcome. Journal of Plastic, Reconstructive & Aesthetic Surgery 2018;71(2):132–9.CrossRefGoogle ScholarPubMed

8. See note 3, Wootson Jr.

9. See note 5, Lantieri et al. 2016:1398–407.

10. GQ. The New Face of Richard Norris [Internet]. Laskas JM, author. [cited 23 Aug 2017]; available at https://www.gq.com/story/richard-norris (last accessed 16 Dec 2018).

11. Harris, EC, Barraclough, B. Suicide as an outcome for mental disorders. A meta-analysis. British Journal of Psychiatry 1997;170:205–28.CrossRefGoogle ScholarPubMed

12. See note 5, Lantieri et al. 2016.

13. See note 5, Lantieri et al. 2016.

14. See note 6, Kiwanuka et al. 2016.

15. Coffman, KL. Psychiatric evaluation of the face transplant candidate. Current Opinion in Organ Transplantation 2015;20(2):222–8.CrossRefGoogle ScholarPubMed

16. Mann, JJ. A current perspective of suicide and attempted suicide. Annals of Internal Medicine 2002;136(4):302–11.CrossRefGoogle ScholarPubMed

17. Lewinsohn, PM, Rohde, P, Seeley, JR. Psychosocial risk factors for future adolescent suicide attempts. Journal of Consulting and Clinical Psychology 1994;62(2):297–305.CrossRefGoogle ScholarPubMed

18. Hawton, K, van Heeringen, K. Suicide. The Lancet 2009;373(9672):1372–81.CrossRefGoogle ScholarPubMed

19. Christiansen, E, Jensen, BF. Risk of repetition of suicide attempt, suicide or all deaths after an episode of attempted suicide: A register-based survival analysis. Australian and New Zealand Journal of Psychiatry 2007;41(3):257–65.CrossRefGoogle ScholarPubMed

20. Runeson, B, Tidemalm, D, Dahlin, M, Lichtenstein, P, Langstrom, N. Method of attempted suicide as predictor of subsequent successful suicide: National long term cohort study. The British Medical Journal 2010;341:c3222.CrossRefGoogle ScholarPubMed

21. Haukka, J, Suominen, K, Partonen, T, Lonnqvist, J. Determinants and outcomes of serious attempted suicide: a nationwide study in Finland, 1996–2003. American Journal of Epidemiology 2008;167(10):1155–63.CrossRefGoogle Scholar

22. Beautrais, AL. Subsequent mortality in medically serious suicide attempts: A 5 year follow-up. Australian and New Zealand Journal of Psychiatry 2003;37(5):595-9.CrossRefGoogle ScholarPubMed

23. Miller, M, Hempstead, K, Nguyen, T, Barber, C, Rosenberg-Wohl, S, Azrael, D. Method choice in nonfatal self-harm as a predictor of subsequent episodes of self-harm and suicide: Implications for clinical practice. American Journal of Public Health 2013;103(6):e61–8.CrossRefGoogle ScholarPubMed

24. See note 20, Runeson et al. 2010.

25. Suokas, J, Suominen, K, Isometsa, E, Ostamo, A, Lonnqvist, J. Long-term risk factors for suicide mortality after attempted suicide: Findings of a 14-year follow-up study. Acta Psychiatrica Scandinavica 2001;104(2):117–21.CrossRefGoogle ScholarPubMed

26. Bukur, M, Inaba, K, Barmparas, G, DuBose, JJ, Lam, L, Branco, BC, et al. Self-inflicted penetrating injuries at a Level I Trauma Center. Injury 2011;42(5):474–7.CrossRefGoogle Scholar

27. Tholpady, SS, DeMoss, P, Murage, KP, Havlik, RJ, Flores, RL. Epidemiology, demographics, and outcomes of craniomaxillofacial gunshot wounds in a level I trauma center. Journal of Cranio-Maxillo-Facial Surgery 2014;42(5):403–11.CrossRefGoogle Scholar

28. See note 18, Hawton, van Heeringen 2009.

29. See note 19, Christiansen, Jensen 2007.

30. See note 23, Miller et al. 2013.

31. Bertolote, JM, Fleischmann, A. Suicide and psychiatric diagnosis: A worldwide perspective. World Psychiatry 2002;1(3):181–5.Google ScholarPubMed

32. Martin, CA, Chapman, R, Rahman, A, Graudins, A. A retrospective descriptive study of the characteristics of deliberate self-poisoning patients with single or repeat presentations to an Australian emergency medicine network in a one year period. BMC Emergency Medicine 2014;14–21.Google ScholarPubMed

33. O’Connor, RC, Smyth, R, Ferguson, E, Ryan, C, Williams, JM. Psychological processes and repeat suicidal behavior: a four-year prospective study. Journal of Consulting and Clinical Psychology 2013;81(6):1137–43.CrossRefGoogle ScholarPubMed

34. Gaynor, JJ, Ciancio, G, Guerra, G, Sageshima, J, Hanson, L, Roth, D, et al. Graft failure due to noncompliance among 628 kidney transplant recipients with long-term follow-up: A single-center observational study. Transplantation 2014;97(9):925–33.CrossRefGoogle ScholarPubMed

35. De Hert, M, Cohen, D, Bobes, J, Cetkovich-Bakmas, M, Leucht, S, Ndetei, DM, et al. Physical illness in patients with severe mental disorders. II. Barriers to care, monitoring and treatment guidelines, plus recommendations at the system and individual level. World Psychiatry 2011;10(2):138–51.CrossRefGoogle ScholarPubMed

36. Rosenberger, EM, Dew, MA, Crone, C, DiMartini, AF. Psychiatric disorders as risk factors for adverse medical outcomes after solid organ transplantation. Current Opinion in Organ Transplantation 2012;17(2):188–92.CrossRefGoogle ScholarPubMed

37. Rosenberger, EM, DiMartini, AF, DeVito Dabbs, AJ, Bermudez, CA, Pilewski, JM, Troyoda, Y, et al. Psychiatric predictors of long-term transplant-related outcomes in lung transplant recipients. Transplantation 2016;100(1):239–47.CrossRefGoogle ScholarPubMed

38. Evans, LD, Stock, EM, Zeber, JE, Morissette, SB, MacCarthy, AA, Sako, EY, et al. Posttransplantation outcomes in veterans with serious mental illness. Transplantation 2015;99(8):e57–65.CrossRefGoogle ScholarPubMed

39. Gysin-Maillart, A, Schwab, S, Soravia, L, Megert, M, Michel, K. A novel brief therapy for patients who attempt suicide: A 24-months follow-up randomized controlled study of the Attempted Suicide Short Intervention Program (ASSIP). PLOS Medicine 2016;13(3):e1001968.CrossRefGoogle Scholar

40. Fleischmann, A, Bertolote, JM, Wasserman, D, De Leo, D, Bolhari, J, Botega, NJ, et al. Effectiveness of brief intervention and contact for suicide attempters: A randomized controlled trial in five countries. Bulletin of the World Health Organization 2008;86(9):703–9.CrossRefGoogle ScholarPubMed

41. Welu, TC. A follow-up program for suicide attempters: Evaluation of effectiveness. Suicide and Life-Threatening Behavior 1977;7(1):17–20.Google ScholarPubMed

42. Smeets, R, Rendenbach, C, Birkelbach, M, Al-Dam, A, Grobe, A, Hanken, H, et al. Face transplantation: On the verge of becoming clinical routine? Biomed Research International 2014;2014:907272.CrossRefGoogle ScholarPubMed

43. See note 15, Coffman 2015:222–8.

44. Pomahac, B, Diaz-Siso, JR, Bueno, EM. Evolution of indications for facial transplantation. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011;64(11):1410–6.CrossRefGoogle ScholarPubMed

45. Losee, JE, Fletcher, DR, Gorantla, VS. Human facial allotransplantation: Patient selection and pertinent considerations. Journal of Craniofacial Surgery 2012;23(1):260-4.CrossRefGoogle ScholarPubMed

46. Siemionow, MZ, Gordon, CR. Institutional review board-based recommendations for medical institutions pursuing protocol approval for facial transplantation. Plastic and Reconstructive Surgery 2010;126(4):1232–9.CrossRefGoogle ScholarPubMed

47. See note 45, Losee et al. 2012.

48. See note 46, Siemionow, Gordon 2010.

49. Lantieri, L, Hivelin, M, Audard, V, Benjoar, MD, Meningaud, JP, Bellivier, F, et al. Feasibility, reproducibility, risks and benefits of face transplantation: A prospective study of outcomes. American Journal of Transplantation 2011;11(2):367–78.CrossRefGoogle ScholarPubMed

50. See note 15, Coffman 2015.

51. Siemionow, M, Gordon, CR. Overview of guidelines for establishing a face transplant program: A work in progress. American Journal of Transplantation 2010;10(5):1290-6.CrossRefGoogle ScholarPubMed

52. See note 44, Pomahac et al. 2011.

53. See note 46, Siemionow, Gordon 2010.

54. See note 15, Coffman 2015.

55. See note 45, Losee et al. 2012.

56. See note 46, Siemionow, Gordon 2010.

57. See note 46, Siemionow, Gordon 2010.

58. See note 44, Pomahac et al. 2011.

59. See note 45, Losee et al. 2012.

60. Jowsey-Gregoire, S, Kumnig, M. Standardizing psychosocial assessment for vascularized composite allotransplantation. Current Opinion in Organ Transplantation 2016;21(5):530–5.CrossRefGoogle ScholarPubMed

61. Bueno, EM, Diaz-Siso, JR, Pomahac, B. A multidisciplinary protocol for face transplantation at Brigham and Women’s Hospital. Journal of Plastic, Reconstructive & Aesthetic Surgery 2011;64(12):1572–9.CrossRefGoogle ScholarPubMed

62. See note 5, Lantieri et al. 2016.

63. See note 5, Lantieri et al. 2016.

64. See note 6, Kiwanuka et al. 2016.

65. See note 5, Lantieri et al. 2016.

66. See note 6, Kiwanuka et al. 2016.

67. See note 5, Lantieri et al. 2016.

68. Coffman, KL, Siemionow, MZ. Face transplantation: Psychological outcomes at three-year follow-up. Psychosomatics 2013;54(4):372–8.CrossRefGoogle ScholarPubMed

69. Barret, JP, Gavalda, J, Bueno, J, Nuvials, X, Pont, T, Masnou, N, et al. Full face transplant: The first case report. Annals of Surgery 2011;254(2):252–6.CrossRefGoogle ScholarPubMed

70. Roche, NA, Blondeel, PN, Vermeersch, HF, Peeters, PC, Lemmens, GM, De Cubber, J, et al. Long-term multifunctional outcome and risks of face vascularized composite allotransplantation. Journal of Craniofacial Surgery 2015;26(7):2038–46.CrossRefGoogle ScholarPubMed

71. Khalifian, S, Brazio, PS, Mohan, R, Shaffer, C, Brandacher, G, Barth, RN, et al. Facial transplantation: The first 9 years. The Lancet 2014;384(9960):2153–63.CrossRefGoogle ScholarPubMed

72. Battin, MP, ed. The Ethics of Suicide: Historical Sources . New York: Oxford University Press USA; 2015.Google Scholar

73. Marsh, I. The uses of history in the unmaking of modern suicide. Journal of Social History 2013;46(3):744–56.CrossRefGoogle Scholar

74. Jamison, K, Hawton, K. The burden of suicide and clinical suggestions for prevention. In: Hawton, K, editor. Prevention and Treatment of Suicidal Behaviour: From Science to Practice. New York: Oxford University Press; 2005.Google Scholar

75. Mann, JJ. Neurobiology of suicidal behavior. Nature Reviews Neuroscience 2003;4(10):819–28.CrossRefGoogle Scholar

76. Klonsky, ED, May AM, Saffer BY. Suicide, suicide attempts, and suicidal ideation. Annual Review of Clinical Psychology 2016;12:307–30.CrossRefGoogle ScholarPubMed

77. See note 72, Battin 2015.

78. See note 73, Marsh 2013.

79. Szasz, TS. The ethics of suicide. The Antioch Review 1971;31(1):7–17.CrossRefGoogle Scholar

80. Ji, J, Kleinman, A, Becker, AE. Suicide in contemporary China: A review of China’s distinctive suicide demographics in their sociocultural context. Harvard Review of Psychiatry 2001;9(1):1–12.CrossRefGoogle ScholarPubMed

81. Crone, C, DiMartini, A. Liver transplant for intentional acetaminophen overdose: A survey of transplant clinicians experiences with recommendations. Psychosomatics 2014;55(6):602–12.CrossRefGoogle ScholarPubMed

82. Cooper, SC, Aldridge, RC, Shah, T, Webb, K, Nightingale, P, Paris, S, et al. Outcomes of liver transplantation for paracetamol (acetaminophen)-induced hepatic failure. Liver Transplantation 2009;15(10):1351–7.CrossRefGoogle ScholarPubMed

83. Thornton, V. Who gets the liver transplant? The use of responsibility as the tie breaker. Journal of Medical Ethics 2009;35(12):739–42.CrossRefGoogle ScholarPubMed

84. Khan, LR, Oniscu, GC, Powell, JJ. Long-term outcome following liver transplantation for paracetamol overdose. Transplant International 2010;23(5):524–9.CrossRefGoogle ScholarPubMed

85. Rhodes, R, Aggarwal, S, Schiano, TD. Overdose with suicidal intent: Ethical considerations for liver transplant programs. Liver Transplantation 2011;17(9):1111–6.Google ScholarPubMed

86. Willey, JZ, Tolchin, BD. Liver transplant for international acetaminophen overdose and hepatic encephalopathy: A conflict between beneficence and justice. Continuum: Lifelong Learning in Neurology 2014;20(3 Neurology of Systemic Disease):681–5.Google Scholar

87. Karvellas, CJ, Safinia, N, Auzinger, G, Heaton, N, Muiesan, P, O’Grady, J, et al. Medical and psychiatric outcomes for patients transplanted for acetaminophen-induced acute liver failure: A case-control study. Liver International 2010;30(6):826–33.CrossRefGoogle ScholarPubMed

88. Appel, J, Vaidya, S. Ethical dilemmas in psychiatric evaluations in patients with fulminant liver failure. Current Opinion in Organ Transplantation 2014;19(2):175–80.CrossRefGoogle ScholarPubMed

89. Forster, J, Bartholome, WG, Delcore, R. Should a patient who attempted suicide receive a liver transplant? Journal of Clinical Ethics 1996;7(3):257–67.Google ScholarPubMed

90. Aulisio, MP, Arnold, RN. Exclusionary criteria and suicidal behavior: Comment on “should a patient who attempted suicide receive a liver transplant”? Journal of Clinical Ethics 1996;7(3):277–83.Google ScholarPubMed

91. Atterbury, CE. Annubis and the feather of truth: Judging transplant candidates who engage in self-damaging behavior. Journal of Clinical Ethics 1996;7(3):268–76.Google Scholar

92. Faeder, S, Moschenross, D, Rosenberger, E, Dew, MA, DiMartini, A. Psychiatric aspects of organ transplantation and donation. Current Opinion in Psychiatry 2015;28(5):357–64.CrossRefGoogle ScholarPubMed

93. O’Grady, JG, Wendon, J, Tan, KC, Potter, D, Cottam, S, Cohen, AT, et al. Liver transplantation after paracetamol overdose. The British Medical Journal 1991;303(6796):221–3.CrossRefGoogle ScholarPubMed

94. See note 83, Thornton 2009.

95. See note 85, Rhodes et al. 2011.

96. See note 88, Appel, Vaidya 2014.

97. See note 90, Aulisio, Arnold 1996.

98. Ethical considerations in the allocation of organs and other scarce medical resources among patients. Council on Ethical and Judicial Affairs, American Medical Association. Archives of Internal Medicine 1995;155(1):29–40.

99. See note 85, Rhodes et al. 2011.

100. See note 90, Aulisio, Arnold 1996:277–83.

101. See note 98, 1995:29–40.

102. Sharkey, K, Gillam, L. Should patients with self-inflicted illness receive lower priority in access to healthcare resources? Mapping out the debate. Journal of Medical Ethics 2010;36(11):661–5.CrossRefGoogle ScholarPubMed

103. Friesen, P. Personal responsibility within health policy: Unethical and ineffective. Journal of Medical Ethics 2018;44(1):53–8.CrossRefGoogle ScholarPubMed

104. See note 98, 1995.

105. See note 98, 1995.

106. See note 85, Rhodes et al. 2011.

107. See note 88, Appel, Vaidya 2014.

108. See note 89, Forster et al. 1996.

109. See note 91, Atterbury 1996.

110. See note 92, Faeder et al. 2015.

111. Carosella, ED, Pradeu, T. Transplantation and identity: A dangerous split? The Lancet 2006;368(9531):183–4.CrossRefGoogle ScholarPubMed

112. Meyer, VE. Hand transplantation. The Journal of Hand Surgery: British & European Volume 2001;26(6):509–10.CrossRefGoogle ScholarPubMed

113. Zhang, LC, Zhao, YB, Hu, WL. Ethical issues in penile transplantation. Asian Journal of Andrology 2010;12(6):795–800.CrossRefGoogle ScholarPubMed

114. BBC News. UK’s first hand transplant operation [Internet]. Gallagher, J, author. [cited 2017 Sep 24]; available at http://www.bbc.com/news/health-20898940 (last accessed 16 Dec 2018).Google Scholar

115. Morris, P, Bradley, A, Doyal, L, Earley, M, Hagen, P, Milling, M, et al. Face transplantation: A review of the technical, immunological, psychological and clinical issues with recommendations for good practice. Transplantation 2007;83(2):109–28.CrossRefGoogle ScholarPubMed

116. Kumnig, M, Jowsey-Gregoire, SG. Key psychosocial challenges in vascularized composite allotransplantation. World Journal of Transplantation 2016;6(1):91–102.CrossRefGoogle ScholarPubMed

117. Sarwer, DB, Ritter, S, Reiser, K, Spitzer, JC, Baumann, BM, Patel, SN, et al. Attitudes towards vascularized composite allotransplantation of the hands and face in an urban population. Vascularized Composite Allotransplantation 2014;1(1-2):22–30.CrossRefGoogle Scholar

118. Plana, N, Kimberly, L, Parent, B, Khouri, K, Diaz-Siso, JR, Frymi, E, et al. The public face of transplantation: The potential of education to expand the face donor pool. Plastic and Reconstructive Surgery 2018;141(1):176–85.CrossRefGoogle ScholarPubMed

119. Parent, B. Informing donors about hand and face transplants: Time to update the uniform anatomical gift act. Journal of Health & Biomedical Law 2015;10(309).Google Scholar

120. Haustein, SV, Sellers, MT. Factors associated with (un)willingness to be an organ donor: Importance of public exposure and knowledge. Clinical Transplantation 2004;18(2):193–200.CrossRefGoogle ScholarPubMed

121. Furr, LA, Wiggins, O, Cunningham, M, Vasilic, D, Brown, CS, Banis, JC Jr., et al. Psychosocial implications of disfigurement and the future of human face transplantation. Plastic and Reconstructive Surgery 2007;120(2):559–65.CrossRefGoogle ScholarPubMed

122. Hartman, RG. Face value: Challenges of transplant technology. American Journal of Law & Medicine 2005;31(1):7–46.CrossRefGoogle ScholarPubMed

123. Rodrigue, JR, Tomich, D, Fleishman, A, Glazier, AK. Vascularized composite allograft donation and transplantation: A survey of public attitudes in the United States. American Journal of Transplantation 2017;17(10):2687–95.CrossRefGoogle ScholarPubMed

124. Neuberger, J, Adams, D, MacMaster, P, Maidment, A, Speed, M. Assessing priorities for allocation of donor liver grafts: Survey of public and clinicians. The British Medical Journal 1998;317(7152):172–5.CrossRefGoogle ScholarPubMed

125. Walter, M, Papachristou, C, Danzer, G, Klapp, BF, Frommer, J. Willingness to donate: An interview study before liver transplantation. Journal of Medical Ethics 2004;30(6):544–50.CrossRefGoogle ScholarPubMed

126. Donor Alliance: Organ Tissue & Donation [Internet]. Donor Alliance Inc.; c2018 [cited 24 Sept 2017]; available at https://www.donoralliance.org/understanding-donation/why-donate/donation-faq/ (last accessed 18 Dec 2018).Google Scholar

127. Donate Life Washington, DC [Internet]. Donate Life DC; c2018 [cited 24 Sept 2017]; available at https://www.donatelifedc.org/frequently-asked-questions/(last accessed 18 Dec 2018).

128. U.S. Department of Health & Human Services: Organ Procurement and Transplantation Network [Internet]. Organ Procurement & Transplantation Network; c2018 [cited 24 Sept 2017]; available at https://optn.transplant.hrsa.gov/resources/guidance/guidance-for-donor-and-recipient-information-sharing/ (last accessed 18 Dec 2018).

129. See note 72, Battin 2015.

130. See note 79, Szasz 1971.

131. Siemionow, M, Gatherwright, J, Djohan, R, Papay, F. Cost analysis of conventional facial reconstruction procedures followed by face transplantation. American Journal of Transplantation 2011;11(2):379–85.CrossRefGoogle ScholarPubMed

132. Hawton, K. Assessment of suicide risk. British Journal of Psychiatry 1987;150:145–53.CrossRefGoogle ScholarPubMed

133. See note 20, Runeson et al. 2010:c3222.

134. See note 22, Beautrais 2003.

135. See note 23, Miller et al. 2013.

136. See note 24, Suokas et al. 2001.

137. Owens, D, Horrocks, J, House, A. Fatal and non-fatal repetition of self-harm. Systematic review. British Journal of Psychiatry 2002;181:193–9.CrossRefGoogle ScholarPubMed

138. Cullberg, J, Wasserman, D, Stefansson, CG. Who commits suicide after a suicide attempt? An 8 to 10 year follow up in a suburban catchment area. Acta Psychiatrica Scandinavica 1988;77(5):598–603.CrossRefGoogle Scholar

139. Pageaux, GP, Michel, J, Coste, V, Perney, P, Possoz, P, Perrigault, PF, et al. Alcoholic cirrhosis is a good indication for liver transplantation, even for cases of recidivism. Gut 1999;45(3):421–6.CrossRefGoogle ScholarPubMed

140. Wiesner, RH, Lombardero, M, Lake, JR, Everhart, J, Detre, KM. Liver transplantation for end-stage alcoholic liver disease: An assessment of outcomes. Liver Transplantation and Surgery 1997;3(3):231–9.CrossRefGoogle ScholarPubMed

141. Varma, V, Webb, K, Mirza, DF. Liver transplantation for alcoholic liver disease. World Journal of Gastroenterology 2010;16(35):4377–93.CrossRefGoogle ScholarPubMed

142. Galai, N, Safaeian, M, Viahov, D, Bolotin, A, Celentano, DD, Study, A. Longitudinal patterns of drug injection behavior in the ALIVE study cohort, 1988–2000: Description and determinants. American Journal of Epidemiology 2003;158(7):695–704.CrossRefGoogle ScholarPubMed

143. Xia, Y, Seaman, S, Hickman, M, Macleod, J, Robertson, R, Copeland, L, et al. Factors affecting repeated cessations of injecting drug use and relapses during the entire injecting career among the Edinburgh addiction cohort. Drug and Alcohol Dependence 2015;151:76–83.CrossRefGoogle ScholarPubMed

144. Evans, JL, Hahn, JA, Lum, PJ, Stein, ES, Page, K. Predictors of injection drug use cessation and relapse in a prospective cohort of young injection drug users in San Francisco, CA (UFO study). Drug and Alcohol Dependence 2009;101(3):152–7.CrossRefGoogle Scholar

145. Hull, SC, Jadbabaie, F. When is enough enough? The dilemma of valve replacement in a recidivist intravenous drug user. The Annals of Thoracic Surgery 2014;97(5):1486–7.CrossRefGoogle Scholar

146. DiMaio, JM, Salerno, TA, Bernstein, R, Araujo, K, Ricci, M, Sade, RM. Ethical obligation of surgeons to noncompliant patients: Can a surgeon refuse to operate on an intravenous drug-abusing patient with recurrent aortic valve prosthesis infection? The Annals of Thoracic Surgery 2009;88(1):1–8.CrossRefGoogle ScholarPubMed

147. Miljeteig, I, Skrede, S, Langorgen, J, Haaverstad, R, Josendal, O, Sjursen, H, et al. Should patients who use illicit drugs be offered a second heart-valve replacement? Tidsskrift for Den Norske Laegeforening 2013;133(9):977–80.CrossRefGoogle ScholarPubMed

148. Tampa Bay Times. Heroin’s surge raises life-or-death medical ethics issue [Internet]. Morelli K, author. [cited 28 Sept 2017]; available at http://www.tbo.com/health/heroins-surge-raises-life-or-death-medical-ethics-issue-20160101/ (last accessed 16 Dec 2018).

149. See note 145, Hull, Jadbabaie 2014:1486–7.

150. See note 146, DiMaio et al. 2009.

151. See note 147, Miljieteig et al. 2013.

152. See note 146, DiMaio et al. 2009.

153. See note 148, Morelli 2016.

154. See note 148, Morelli 2016.

155. DrugRehab. Florida’s opioid crisis fueled by pill mills [Internet]. Johnson P, author. [cited 28 Sept 2017]; available at https://www.drugrehab.com/2017/03/01/florida-pill-mill-crisis/ (last accessed 18 Dec 2018).