Hoping for a miracle: supporting patients in transplantation and cardiac assist programs.
OBJECTIVE
Palliative medicine is often viewed as a medical specialty reserved for end of life care. This review focuses on the role that palliative care can play in transplant and cardiac assist device programs, along the continuum of a patient's disease course.


RESULTS
In general, transplant and cardiac assist programs do not incorporate palliative medicine during the treatment course, but rather reserve it for when the patient is approaching death and is no longer a candidate for transplant or device therapy. There is a new shift, however, to viewing the practice of aggressive medicine and palliative medicine as 'shared care' so as to optimize the patient's quality of life throughout his or her illness.


CONCLUSIONS
Transplant and cardiac assist device programs should not exclude the practice of palliative care in their daily work. Palliative care is not 'giving up' rather it is optimizing the quality of a patient's life irrespective of the level of disease severity and prognosis.
Bramstedt
Katrina A
KA
California Pacific Medical Center, Program in Medicine and Human Values, San Francisco, CA 94115, USA. txbioethics@yahoo.com
D006353:Heart-Assist Devices; D006801:Humans; D016377:Organ Transplantation; D010166:Palliative Care / Q000458:organization & administration*; D016414:Resuscitation Orders