Emergency consults in the setting of transplant medicine: Dilemmas for social workers and bioethicists

Transplant medicine is a setting filled with emotions and uncertainty. The clinical cases are frequently complex and affected by psychosocial and ethics variables as well as time constraints. For the nonurgent patient, there is usually ample time to complete the necessary evaluations. In urgent situations, however, time is limited and social workers and ethicists often find themselves racing to conduct assessments that provide information that is important for decision making regarding a patient's suitability for organ transplantation. The same can be said for decisions about insertion of ventricular assist devices and living organ donation. Using 2 cases, we explore the practice of emergency consultation (distinguished from "curbside consultation") and offer guidance for conducting these assessments.