| Ethical Considerations for Ventricular Assist Device Support: A 10-Point Model. | |
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MedLine Citation:
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PMID: 21642842 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The potential for long-term support on a ventricular assist device (VAD) in the bridge-to-transplant (BTT) and destination therapy (DT) settings has created unprecedented ethical challenges for patients and caregivers. Concerns include the patient's adaptation to life on a device and the ethical, clinical, and practical issues associated with living on mechanical support. On the basis of our experience treating 175 consecutive VAD patients, we have developed a model to address the ethical and psychosocial needs of patients undergoing VAD implantation. Patient preparation for VAD implantation encompasses three phases: 1) initial information regarding the physical events involved in implantation, risks and benefits of current device technology, and the use of VAD as a rescue device; 2) preimplant preparation including completion of advance directives specific to BTT/DT, competency determination, and identifying a patient spokesperson, multidisciplinary consultants, and cultural preferences regarding device withdrawal; and 3) VAD-specific end-of-life issues including plans for device replacement and palliative care with hospice or device withdrawal. This three-phase 10-point model addresses the ethical and psychosocial issues that should be discussed with patients undergoing VAD support. |
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Authors:
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Ralph J Petrucci; Lynne A Benish; Barbara L Carrow; Lisa Prato; Shelley R Hankins; Howard J Eisen; John W Entwistle |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-2 |
Journal Detail:
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Title: ASAIO journal (American Society for Artificial Internal Organs : 1992) Volume: - ISSN: 1538-943X ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9204109 Medline TA: ASAIO J Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the *Department of Psychiatry, Drexel University College of Medicine/Hahnemann University Hospital; †Temple University Hospital, Philadelphia, Pennsylvania; ‡Thoratec Corporation, Pleasanton, California; §The Cardiac Center, Children's Hospital of Philadelphia; ¶ Division of Cardiology, Department of Medicine, and ∥Department of Cardiothoracic Surgery, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, Pennsylvania. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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