title: Overdose with suicidal intent: ethical considerations for liver transplant programs.
abstract: Liver transplantation (LT) programs encounter patients with fulminant hepatic failure resulting from suicide attempts involving acetaminophen or multidrug ingestion. Members of transplant teams often have different opinions about whether these patients should be offered transplantation. Disagreements can delay the transfer of these patients to a transplant facility and negatively affect their management. Currently, transplant programs have no guidelines to help them with their decisions about the appropriateness of LT for these patients. Here we present a clinical case encountered at our facility, and we discuss ethical principles that should help programs to make informed decisions about transplantation for these patients.
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Rosamond
authors.initials: R
authors.lastname: Rhodes
authors.forename: Sourabh
authors.initials: S
authors.lastname: Aggarwal
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
mesh_terms: D000082:Acetaminophen / Q000633:toxicity*; D000328:Adult; D062787:Drug Overdose; D004992:Ethics, Medical; D005260:Female; D006801:Humans; D017114:Liver Failure, Acute / Q000601:surgery / Q000628:therapy*; D016031:Liver Transplantation / Q000941:ethics* / Q000379:methods*; D001523:Mental Disorders / Q000150:complications; D018579:Patient Selection; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D000082:Acetaminophen