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AN ADDICT'S REQUEST FOR A LIVER TRANSPLANT

Presenting Ethical Dilemma:

A 35 year old divorced female patient is a candidate for a liver transplant. She has abused street drugs since the age of 15. The court awarded custody of her six children to the father. She failed the drug screen test upon hospital admission for work-up as a transplant candidate.

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AN ADDICT'S REQUEST FOR A LIVER TRANSPLANT
A 35 year old divorced female patient is a candidate for a liver transplant. She has abused street drugs since the age of 15. In this case even thought the court has awarded the custody of her six children to her husband, the children will need their mother and if she is cured of drug abuse then her children will benefit from the presence of their mother.
The ethical principle is :
"A physician shall be dedicated to providing competent medical care, with compassion and respect for human dignity and rights."

Psychology consult indicates "severe frontal lobe compromise." Psychiatric consult reports "no psychosis, but severe organic brain encephalopathy." Neurology consults reports "beta inducing medication which suggests continued use of methamphetamines." In short it means that the possibility of the drug addict returning to methampehtamines is high if the operation for transplant is done. However, if the transplantation is done and if followed up by strong psychiatric care including close supervision, the condition can be changed.

The ethical principle is :
A physician shall, while caring for a patient, regard responsibility to the patient as paramount

She states she wants to have the transplant to live. The physician has to believe what she says and help her not only with the transplant but also with post operative psychiatric care, close supervision and support.
The ethical principle is:
A physician shall support access to ...

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