The ethical conundrum: Conflicting advocacy positions in advanced heart failure therapy.


Journal

Clinical transplantation
ISSN: 1399-0012
Titre abrégé: Clin Transplant
Pays: Denmark
ID NLM: 8710240

Informations de publication

Date de publication:
03 2019
Historique:
received: 02 12 2018
accepted: 20 01 2019
pubmed: 29 1 2019
medline: 2 5 2020
entrez: 29 1 2019
Statut: ppublish

Résumé

It is estimated that nearly 6.5 million Americans over the age of 20 suffer from heart failure. Heart failure is the leading cause of hospitalization in patients over 65 years of age, and carries with it a 5-year mortality of nearly 50%. Despite advances in medical therapy, treatment for medically refractory end-stage, advanced heart failure is limited to heart transplant, mechanical circulatory support (MCS), or palliative care only. Patient selection in advanced heart failure (AHF) therapy is complex. Not only are the patients medically complicated, but providers are biased by their individual and collective experience with similar and dissimilar patients. Clinicians caring for AHF patients balance competing clinical and ethical demands, which appropriately leads to professional debate and disagreement. These debates are constructive because they clarify ethical and professional commitments and help to ensure fair and equitable treatment of AHF patients.

Identifiants

pubmed: 30689225
doi: 10.1111/ctr.13489
doi:

Substances chimiques

Cardiotonic Agents 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e13489

Informations de copyright

© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Auteurs

Denise M Dudzinski (DM)

Department of Bioethics & Humanities, University of Washington School of Medicine, Seattle, Washington.
UW Medicine Ethics Consultation Service, Seattle, Washington.

Claudius Mahr (C)

Department of Medicine, Division of Cardiology, Regional Heart Center, University of Washington Medical Center, Seattle, Washington.

Jason Bjelkengren (J)

Advanced Heart Failure, Cardiac Transplant & Mechanical Circulatory Support, Regional Heart Center, University of Washington Medical Center, Seattle, Washington.

Nahush A Mokadam (NA)

Division of Cardiothoracic Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio.

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