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Ethical Considerations for Ventricular Assist Device Support: A 10-Point Model
Journal article   Open access   Peer reviewed

Ethical Considerations for Ventricular Assist Device Support: A 10-Point Model

Ralph J. Petrucci, Lynne A. Benish, Barbara L. Carrow, Lisa Prato, Shelley R. Hankins, Howard J. Eisen and John W. Entwistle
ASAIO journal (1992), v 57(4), pp 268-273
01 Jul 2011
PMID: 21642842
url
https://doi.org/10.1097/mat.0b013e3182223269View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Engineering Engineering, Biomedical Life Sciences & Biomedicine Science & Technology Technology Transplantation
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. ASAIO Journal 2011; 57:268-273.

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31 citations in Scopus

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Collaboration types
Industry collaboration
Domestic collaboration
Web of Science research areas
Engineering, Biomedical
Transplantation
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