Kaufman Beth D, Jessup Mariell
Lucille Packard Children's Hospital, Stanford University Pediatric Cardiology, Stanford University, Palo Alto, CA 94304, USA.
World J Pediatr Congenit Heart Surg. 2013 Jan;4(1):75-9. doi: 10.1177/2150135112469972.
At the Ethics of the Heart II: Ethical and Policy Challenges in Congenital Heart Disease Conference, March 16-17, 2012 in Philadelphia, Pennsylvania, one of the sessions focused on the issues related to end-stage heart failure in patients with congenital heart disease including utilizing the therapy of heart transplantation. This article will summarize the session related to repeat heart transplant that was based on discussion of actual patient cases, two adults and one pediatric, presented, respectively, by an adult and a pediatric heart transplant specialist. Outcome data related to retransplant for both adult and pediatric heart transplant populations are reviewed. The complicated ethical issues related to considerations of beneficence versus nonmalfeasance by a medical care team for an individual patient, patient autonomy related to adherence, and obligations to society to fairly allocate the scarce precious resource of donor organs are discussed.
在2012年3月16日至17日于宾夕法尼亚州费城召开的“心脏伦理学II：先天性心脏病的伦理与政策挑战”会议上，其中一场会议聚焦于先天性心脏病患者终末期心力衰竭的相关问题，包括心脏移植治疗的应用。本文将总结基于实际患者病例讨论的再次心脏移植会议内容，这些病例分别由一位成人心脏移植专家和一位儿科心脏移植专家呈现，涉及两名成人患者和一名儿科患者。回顾了成人和儿科心脏移植人群再次移植的结果数据。讨论了医疗团队针对个体患者在考虑行善与不伤害原则时所涉及的复杂伦理问题、与依从性相关的患者自主权，以及社会在公平分配稀缺珍贵的供体器官资源方面的义务。
