Ethics in Rehabilitation: Access to Prosthetics and Quality Care Following Amputation

The most recent large-scale study of amputation in the United States found that 1.6 million people were living with limb loss in the country in 2005 With 185,000 amputations occurring annually [2], the total number of people with amputation in the US (accounting for mortality) is projected to double by the year 2050. The most common causes of amputation are vascular disease, trauma, cancer, and congenital malformation. Vascular disease and trauma account for 54 percent and 44 percent of the current prevalence, respectively, while less than 2.5 percent of people who have had amputations cite cancer or congenital deformity as the cause [3]. The rising incidence of amputations observed in the United States thus can largely be attributed to vascular disease and comorbid diabetes, the latter accounting for more than 60 percent of nontraumatic amputations in the United States today Furthermore, the number of people living with diabetes in the US in 2011-25.8 million-is predicted to double by 2030 [ 1, 5]. As a result, amputation presents an ever-increasing challenge to our health care system.