Bramstedt Katrina A, Chalfant Annette, Wright Carol
Cleveland Clinic, Cleveland, Ohio, USA.
Prog Transplant. 2007 Mar;17(1):36-9. doi: 10.1177/152692480701700105.
Transplant medicine is a setting filled with emotions and uncertainty. The clinical cases are frequently complex and affected by psychosocial and ethics variables as well as time constraints. For the nonurgent patient, there is usually ample time to complete the necessary evaluations. In urgent situations, however, time is limited and social workers and ethicists often find themselves racing to conduct assessments that provide information that is important for decision making regarding a patient's suitability for organ transplantation. The same can be said for decisions about insertion of ventricular assist devices and living organ donation. Using 2 cases, we explore the practice of emergency consultation (distinguished from "curbside consultation") and offer guidance for conducting these assessments.
移植医学是一个充满情感和不确定性的领域。临床病例通常很复杂,受到社会心理、伦理变量以及时间限制的影响。对于非紧急患者,通常有足够的时间完成必要的评估。然而,在紧急情况下,时间有限,社会工作者和伦理学家常常发现自己争分夺秒地进行评估,以提供对于决定患者是否适合器官移植至关重要的信息。对于心室辅助装置植入和活体器官捐赠的决策也是如此。我们通过两个案例探讨了紧急会诊(区别于“床边会诊”)的实践,并为进行这些评估提供指导。