Managing organ transplant issues. A guide for approaching controversial, high tech procedures

With the increase in the requests for high intensity medical procedures such as organ transplantation, the physician executive often is placed in the middle between competing interests. Whether he or she represents the provider or payer side, there is frequently great pressure to make decisions involving complex medical situations in short time-frames. It is necessary to have in place a fair, consistent approach to handling such issues in order to withstand both medical and ethical scrutiny. A process is detailed that will lead the organization to developing such an approach. Although presented in the context of transplant issues, this process can be applied to any similar high technology procedure.