When organs match and health beliefs don't. Bioethical challenges

This paper addresses the problems that psychologically unprepared individuals may experience when the socioethnic aspects of their health belief systems are not addressed in the decision-making process for renal transplantation. Case studies of two Hispanic adolescents are presented. A cognitive behavioral therapeutic approach that specifically concentrates on changing health beliefs related to organ transplant is recommended to help maximize the probability of a successful transplant. Past assumptions by psychosocial transplant teams that make self-esteem the primary basis on which to predict transplant or therapeutic outcome are challenged. The exchange of scientific cognition modifying strategies to address health beliefs that are deleterious to biologic and psychologic survival are recommended as a critical part of biomedical engineering practice for the next decade.