https://scholars.lib.ntu.edu.tw/handle/123456789/464910
標題: | Perspectives of Transplant Professionals on the Values, Ethics, and Challenges of Living Kidney Donor Evaluation in Asia | 作者: | Tong A. Chapman J.R. Kee T. Li P.K.T. DANIEL FU-CHANG TSAI Wong G. Craig J.C. |
公開日期: | 2015 | 出版社: | Lippincott Williams and Wilkins | 卷: | 99 | 期: | 7 | 起(迄)頁: | 1386-1395 | 來源出版物: | Transplantation | 摘要: | Deceased donor rates in Asia are among the lowest in the world. This has necessitated a reliance on living kidney donation, which has given rise to concerns about donor motivation and assessment in this region. We aimed to describe transplant professional perspectives on living kidney donor evaluation in Asia. Methods Face-to-face, semistructured interviews were conducted with 53 transplant professionals (nephrologists [n = 21], surgeons/urologists [n = 17], coordinators [n = 7], social workers [n = 5], ethicists [n = 2], psychologist [n = 1]) from 20 centers in 10 countries. Transcripts were analyzed thematically to identify themes. Results The theme of traversing vulnerability overarched 4 themes. Vigilance against exploitation of the vulnerable meant mitigating the threat of commercial transplantation, combating disparities, and verifying volunteerism. Maintaining clarity of professional roles encompassed the perceived necessity of legal safeguards to determine legitimacy of relationships, ensuring informed consent, demarcating responsibilities, minimizing conflict of interest, meeting community expectations, and resolving ambivalence regarding donor risk. Societal plight driving caution about living kidney donor assessment was emphasized in the context of poverty and desperation, higher risk of disease, and lack of social security. Navigating sociocultural barriers acknowledged the centrality of the family, economic priorities, distrust in modern medicine, generational traditions, and emotional opacity limiting their ability to gauge donor motivation. Conclusions Moral, professional, sociocultural and societal vulnerabilities contribute to the barriers and ethical quandaries in living kidney donation in Asia. Strategies are needed to address culturally based anxieties and disparities in living donation. Transplant professionals depend on strong legislation and policies to prevent exploitation of living donors. Copyright ? 2015 Wolters Kluwer Health, Inc. All rights reserved. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84940643726&doi=10.1097%2fTP.0000000000000534&partnerID=40&md5=b15da86e4d5dd96677ecc5c529f0cd19 https://scholars.lib.ntu.edu.tw/handle/123456789/464910 |
ISSN: | 0041-1337 | DOI: | 10.1097/TP.0000000000000534 | SDG/關鍵字: | adult; aged; Article; clinical practice; controlled study; female; health care policy; health disparity; health education; human; kidney donor; legal aspect; living donor; major clinical study; male; medical ethics; medical service; medical society; middle aged; patient safety; physician attitude; priority journal; professional knowledge; professional standard; risk assessment; risk factor; social aspect; social class; social interaction; social psychology; social security; volunteer; young adult; adverse effects; Asia; attitude to health; clinical trial; cognition; cultural factor; donor selection; ethics; health care disparity; health care personnel; health personnel attitude; informed consent; interview; kidney transplantation; legislation and jurisprudence; multicenter study; perception; psychology; qualitative research; social behavior; socioeconomics; supply and distribution; vulnerable population; Adult; Aged; Asia; Attitude of Health Personnel; Cultural Characteristics; Donor Selection; Female; Health Knowledge, Attitudes, Practice; Health Personnel; Healthcare Disparities; Humans; Informed Consent; Interviews as Topic; Kidney Transplantation; Living Donors; Male; Middle Aged; Patient Safety; Perception; Professional Role; Qualitative Research; Risk Assessment; Risk Factors; Social Responsibility; Socioeconomic Factors; Volition; Vulnerable Populations; Young Adult |
顯示於: | 醫學教育暨生醫倫理學科所 |
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