Ethical Challenges of Bioprinted and Lab-Grown Skin Substitutes in Burn Care

Severe burns continue to impose significant global morbidity and mortality, particularly where surgical and critical-care resources are limited. As survival has improved, attention has shifted toward optimizing reconstruction. Bioprinted and lab-grown skin substitutes-building on advances in tissue engineering, cellular scaffolds, and 3D bioprinting-offer new possibilities for coverage, yet raise ethical, legal, and distributive challenges that remain underexamined in burn care. A narrative review was conducted using PubMed, Embase, Web of Science, and Google Scholar (2010-2025), supplemented by foundational legal and bioethics literature. Sources were selected for conceptual and policy relevance to ownership, consent, commercialization, intellectual property, and equity in regenerative skin technologies. Fifty publications spanning burn surgery, biobanking, organoid governance, IP law, and global health were synthesized inductively. Five major ethical domains emerged: (1) ambiguous ownership and ontological status of hybrid bioprinted tissues; (2) inadequacy of consent processes to address commercialization and downstream uses of patient-derived cells; (3) complex intellectual property environments that may restrict access and clinical innovation; (4) distributive injustice driven by high costs and global resource disparities; and (5) a near absence of empirical ethics research involving burn patients or care teams. Bioprinted and lab-grown skin substitutes could transform burn reconstruction, but current ethical and regulatory frameworks lag behind. Addressing ownership, consent, commercialization, and equity-supported by robust empirical engagement with patients-is essential for responsible integration of these technologies into burn care.