In summary, the assessment of liver transplant patients pretransplant is challenging and includes potential clinical, ethical, and social factors. Thus, as psychiatric consultants, our job should be to find data regarding those risk factors for which there is evidence supporting predictive value: the presence or absence of functional social support; the extent of substance use; sobriety and conditions under which it was achieved; a history of medical nonadherence; and the presence of psychiatric disorders. These appear to be the most significant factors relating to the success of a transplant. Whenever possible we should use sources of collateral information (e.g., family or friends) to verify the facts provided, particularly in patients with hepatic encephalopathy. In addition, developing a good collaborative relationship with the social workers and nurse coordinators of the transplant team will be rewarding, because they usually know the patient much better than you do and can provide a wealth of useful and corroborating (or conflicting) information that may be helpful in making decisions regarding the patient's truthfulness with the process. The use of objective diagnostic tools, such as the SIPAT (3), assists clinicians not only in eliminating the emotional factor from the assessment but also in presenting the facts. Our job as consultants should not be to make a determination regarding the patient's worthiness as a candidate but to assist the transplant selection committee in making the best clinical decision based on current available data.