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Ethics of Organ Transplantation in Persons with Intellectual Disability

      Historically, individuals with intellectual disability and end-stage organ disease were discriminated against by transplant professionals and often excluded from transplantation waitlists. Despite antidiscrimination legislation, some transplant programs continue to include intellectual disability as a relative, if not an absolute, contraindication to listing for an organ; this is true for both pediatric and adult individuals in end-stage organ disease. This commentary opposes the absolute exclusion of patients with intellectual disability and end-stage organ disease from transplantation waitlists provided that the candidates are expected to gain a predefined minimum benefit threshold of life-years and quality-adjusted-life years. Intellectual disability is one of many factors that should be considered in determining transplant eligibility and each candidate should have an individualized interdisciplinary assessment.

      Keywords

      Abbreviations:

      ADA (Americans with Disability Act), MCS (Minimally conscious state), PVS (Persistent vegetative state), QALYs (Quality-adjusted life years)
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