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What Actually Happened

The transplant coordinator scheduled a meeting that included numerous members of the multidisciplinary team, among them the transplant surgeon, a social worker, a psychologist, and an ethics consultant. The ethics consultant outlined the ethical issues and made a recommendation. The consultant argued that the question whether the patient should again be listed as a transplant candidate really came down to the kind of environment that could be provided during aftercare. That is, if a rather structured living environment—one more structured and supportive than the previous independent living facility—could be found for the patient, then retransplantation might be warranted. But without such an environment, the patient would again probably fail to adhere to the medical and psychological treatment regimen necessary for a successful life as a transplant recipient. The psychologist, who had been working closely with the ethics consultant, concurred in this opinion.