advice

[Guest guest]

I'd like some advice. Even though I'm on the transplant list, I'm

moving ahead with my life since my labs are basically normal. As part

of that, I'm applying to a one-year internship program locally in

clinical psychology for next fall (I'm a PhD candidate in my last

year on campus). The internship is a professional position -- full-

time, full-benefits, meager salary well above what I'm earning as a

student, etc. My question is this: should I disclose info about my

health and my status on the transplant list when I apply?

The internships are fairly competitive, though I feel confident I'm

qualified and I have some inside help pulling for me. The internship

director knows what's going on and said she has mixed feelings about

whether I should include it as follows: Reasons not to disclose - no

legal obligation (is this true?), the internship director feels it

should play no role in the admissions committee's decision, it is

impossible to predict when I'll have the transplant (my MELD is only

9); reasons to disclose - could impact clinical decisions during the

internship and thus will be disclosed after I'm there AND some

supervisors may feel resentful if they feel like I was hiding

something, there is no way to predict whether I'll be able to

complete the internship. As I said, the internship director already

knows so it likely won't make a difference, but she does not intend

to discuss it with others on the admissions committee if I don't

disclose it in the application materials, as she wants me considered

on my merits. Nonetheless, I feel an ethical pull to discuss it as

early as possible.

What do others think?

Philip

-------------------------

PSC '94. Waiting for Tx since 6/03, though labs & sx improved since

then. Live donor on standby if and when sx return.

Age 30, married 9 years, 3 children (8,4,1). PhD candidate, clinical

psychology. Hobby: Singer (w/ master's in opera) and church choir

director.

[Guest guest]

Philip,

I have struggled with this same ethical

dilemma in terms of post-Tx jobseeking,

both 18 years ago and now. It has been a topic of considerable discussion on

other lists, particularly one whose members are all Tx candidates or recipients. There is no right or

wrong answer, other than that you have to make a choice that you will be

comfortable with. However, you should make sure that it is an informed choice,

based on practical reality rather than worst-case supposition. You are

fortunate to have such a strong advocate as the internship director on your

side. You do not have a legal obligation to disclose the fact that you have a

condition that may require a transplant at some time in the future. Even if its

present effect on you was such that you were partially disabled by it, you

would only be obligated to disclose that to the extent that the disability affected

your performance of the responsibilities of the position, and only if you

wanted them to provide accommodations to your disability. You are also not

bound ethically, IMHO, to disclose it. It would be a different matter if your MELD score was 26 and your doctors had told you that

you were #1 on the List. But at this point, you might very well complete the

internship without incident. I’m not sure what you mean when you say it

might affect clinical decisions when you are in the position. As for you not

being able to complete the internship, that is a risk they take when they hire

anyone. As the Director says, you should be considered on the merits alone, and

if you disclose this in your application it will work against you.

In 1986 I worked on the Boy Scouts of

America Presidential Good Turn, which was a year-long national Donor Awareness

program. I had the opportunity to have a conversation with the Director of the

program, who was “lent” to the Boy Scouts

by the major corporation at which he was Senior Vice President for Purchasing. He

told me that he had been given the opportunity to select his own successor, and

chose the best-qualified man on his staff. Only after the selection had been submitted

to the Board did he find out that the man had been a kidney transplant

recipient 10 years earlier. Of course it made no difference to him, but there

was considerable opposition among the Board members, based solely on the fact

that the candidate had had a transplant. The Senior V.P. finally was able to

get him approved, but only after reminding the Board of the reason they had to

make this selection (the fact that they were underwriting a national effort to

make transplants available to more people), and threatening to not only

withdraw from working with the Boy Scouts, but to leave the company as well.

Many things may have changed in 17 years,

but the attitude that Board had is still present in business and academia.

Good luck with your application.

Steve

Rahn

L Tx 9/6 & 9/8 '85.

(Wash. U-STL)

(re) Born on the

4th of July, 2003 (U of Iowa)

www.presumedconsent.org

" Face

the Worst, Expect the Best,

Do

the Most, Forget the Rest "