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Cognitive functioning as a contraindication to organ transplant surgery: Dilemmas encountered in medical decision making

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Abstract

A case is presented to illustrate some of the difficulties encountered when providing psychological consultation to evaluate the readiness of patients for pediatric heart-lung transplantation. The outcome of complex medical decision making can often hinge on information provided by the psychological consultant who is attempting to simultaneously serve the needs of the patient as well as the transplant team. Ethical dilemmas frequently arise when medical decision making is driven by limited health care resources and cost constraints. The utility of cognitive functioning as a variable in pediatric transplant decision making is discussed. Recommendations are made for further work in this area on both conceptual and empirical grounds to guide the integration of psychological information into transplant decision making as health care delivery continues to evolve in the future.

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References

  • Baum, D., & Bernstein, D. (1993). Heart and lung transplantation in children. In I. H. Gessner & B. E. Victoria (Eds.),Pediatric cardiology: A problem oriented approach (pp. 245–252). Philadelphia: W. B. Saunders.

    Google Scholar 

  • Bright, M. J., Craven, J. L., Kelly, P. J., & Toronto Lung Transplant Group (1990). Assessment and management of psychosocial stress in lung transplant candidates.Health and Social Work, 15, 125–132.

    Google Scholar 

  • Didlake, R. H., Dreyfus, K., Kerman, R. H., Van Buren, C. T., & Kahan, B. D. (1988). Patient noncompliance: A major cause of late graft failure in cyclosporina treated renal transplants.Transplantation Proceedings, 20, 63–69.

    Google Scholar 

  • Ferencz, C., Neill, C. A., Boughman, J. A., Rubin, J. D., Brenner, J. I., & Perry, L. W. (1989). Congenital cardiovascular malformations associated with chromosome, abnormalities: An epidemiologic study.Journal of Pediatrics, 114, 79–86.

    PubMed  Google Scholar 

  • Freeman, A., Davies, L., Libb, J. W., & Craven, J. (1992). Assessment of transplant candidates and prediction of outcome. In J. Craven & G. M. Rodin (Eds.),Psychiatric aspects of organ transplantation (pp. 9–21). New York: Oxford University Press.

    Google Scholar 

  • Jastak, S., & Wilkinson, G. S. (1984).Wide Range Achievement Test—Revised. Wilmington, DE: Jastak Associates.

    Google Scholar 

  • Lowry, F., & Martin, D. (1992). Ethical considerations in transplantation. In J. Craven & G. M. Rodin (Eds.),Psychiatric aspects of organ transplantation (pp. 108–121). New York: Oxford University Press.

    Google Scholar 

  • McCabe, M. A. (1996). Involving children and adolescents in medical decision making: Developmental and clinical considerations.Journal of Pediatric Psychology, 21, 505–516.

    PubMed  Google Scholar 

  • Neill, C. A., Clark, E. B., & Clark, C. (1992).The heart of a child. Baltimore, MD: The Johns Hopkins University Press.

    Google Scholar 

  • Nussbaum, P. D., & Goldstein, G. (1992). Neuropsychological sequelae of heart transplantation: A preliminary review.Clinical Psychology Review, 12, 475–483.

    Google Scholar 

  • Orenstein, D. M., & Kaplan, R. M. (1991). Measuring the quality of well-being in cystic fibrosis and lung transplantation.Chest, 100, 1016–1018.

    PubMed  Google Scholar 

  • Sexson, S., & Rubenow, J. (1992). Transplants in children and adolescents. In J. Craven & G. M. Rodin (Eds.),Psychiatric aspects of organ transplantation (pp. 33–49). New York: Oxford University Press.

    Google Scholar 

  • Thorndike, R. L., Hagen, E. P., & Sattler, J. M. (1986).Guide for administering and scoring the Stanford-Binet Intelligence Scale: Fourth edition. Chicago: Riverside.

    Google Scholar 

  • Warner, J. O. (1991). Heart-lung transplantation: All the facts.Archives of Disease in Childhood, 66, 1013–1017

    PubMed  Google Scholar 

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Collins, T.L., Wayne Holden, E. & Scheel, J.N. Cognitive functioning as a contraindication to organ transplant surgery: Dilemmas encountered in medical decision making. J Clin Psychol Med Settings 3, 413–422 (1996). https://doi.org/10.1007/BF01994023

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