Heart transplantation without informed consent: Discussion of a case

A. M. Grande, M. Rinaldi, C. Goggi, P. Politi, M. Viganò

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To discuss informed consent to heart transplantation in the case of an intensive care unit (ICU) patient: relatives' informed consent was refused by the patient himself whose cognitive ability appeared to be reasonable for the purpose. Setting: ICU of a university teaching hospital. Patient: a 62-year-old man who underwent myocardial revascularization had in the immediate post-operative hemodynamic instability, continuous serious arrhythmias, ventilatory support, fentanyl infusion. Heart transplantation could be the only chance for his survival. Intervention: heart transplantation. Results, despite patient's refusal, we decided to hold the relative's consent as valid, and transplantation was accordingly performed, to the subsequent satisfaction of the patient. Conclusions: Our decision was based on two beliefs: (1) the severity of the patient's clinical condition may have impaired his cognitive abilities; (2) the very same conditions may mask impairment and certainly make reliable assessment of cognition and judgment impossible. This being so, the preservation of life assumes priority.

Original languageEnglish
Pages (from-to)251-254
Number of pages4
JournalIntensive Care Medicine
Volume24
Issue number3
DOIs
Publication statusPublished - 1998

Fingerprint

Heart Transplantation
Informed Consent
Aptitude
Intensive Care Units
Myocardial Revascularization
Fentanyl
Masks
Patient Satisfaction
Teaching Hospitals
Cognition
Cardiac Arrhythmias
Transplantation
Hemodynamics
Survival

Keywords

  • Decision making
  • Heart failure
  • Heart transplantation
  • Informed consent

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Heart transplantation without informed consent : Discussion of a case. / Grande, A. M.; Rinaldi, M.; Goggi, C.; Politi, P.; Viganò, M.

In: Intensive Care Medicine, Vol. 24, No. 3, 1998, p. 251-254.

Research output: Contribution to journalArticle

Grande, A. M. ; Rinaldi, M. ; Goggi, C. ; Politi, P. ; Viganò, M. / Heart transplantation without informed consent : Discussion of a case. In: Intensive Care Medicine. 1998 ; Vol. 24, No. 3. pp. 251-254.
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