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 language | English |
|---|---|
| Pages (from-to) | 251-254 |
| Number of pages | 4 |
| Journal | Intensive Care Medicine |
| Volume | 24 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1998 |
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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 journal › Article
}
TY - JOUR
T1 - Heart transplantation without informed consent
T2 - Discussion of a case
AU - Grande, A. M.
AU - Rinaldi, M.
AU - Goggi, C.
AU - Politi, P.
AU - Viganò, M.
PY - 1998
Y1 - 1998
N2 - 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.
AB - 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.
KW - Decision making
KW - Heart failure
KW - Heart transplantation
KW - Informed consent
UR - http://www.scopus.com/inward/record.url?scp=0031945442&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031945442&partnerID=8YFLogxK
U2 - 10.1007/s001340050559
DO - 10.1007/s001340050559
M3 - Article
C2 - 9565808
AN - SCOPUS:0031945442
VL - 24
SP - 251
EP - 254
JO - Intensive Care Medicine
JF - Intensive Care Medicine
SN - 0342-4642
IS - 3
ER -