Informed consent issues in the cardiac transplantation evaluation.
As consultation-liaison psychiatrists to a cardiac transplantation team, we have observed various informed consent issues that are particularly associated with evaluation for cardiac transplantation. We discuss complicating factors that relate to each component of informed consent and present the defense mechanism of denial as a barrier to making the decision to accept or refuse transplantation. Changes in the evaluation protocol could preclude existing impediments to provision of information and patient autonomy; however, certain intrapsychic issues must be recognized as ongoing clinical realities to be addressed as the doctrine of informed consent continues to evolve.
Myers
B
B
Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, KY 40292.
Kuhn
W F
WF
D000328:Adult; D003657:Decision Making; D003717:Denial, Psychological; D030881:Disclosure; D016027:Heart Transplantation; D006801:Humans; D007258:Informed Consent; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D018570:Risk Assessment; D012307:Risk Factors; D014836:Volition