对于末期病患者在移植可及性方面的非描述性合规性标签的挑战
Benjamin Peticca1, Tomas M Prudencio1, Samuel G Robinson1
1Department of Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA 19140, United States.
World journal of nephrology
|April 10, 2024
概括
使用"不合规"等术语不公平地责怪患者,并限制对器官移植的准入. 这种语言忽视了健康的社会决定因素,并导致了移植机会的减少,特别是对于少数群体.
科学领域:
- 医学伦理学医学伦理学
- 移植医学是一种移植医学.
- 卫生公平性健康公平性
背景情况:
- 临床语言,如"不合规"或"不坚持",不公平地将责任归咎于患者.
- 这些条款可能会导致等待列表失活,并减少获得挽救生命的器官移植的机会.
- 现有的健康社会决定因素和保险覆盖不足导致患者难以遵守护理方案.
研究的目的:
- 分析非描述性临床语言对患者护理和移植机会的影响.
- 突出"不合规"等术语如何在器官分配中延续偏见和主观性.
- 倡导在医疗记录和临床决策中使用更准确和以患者为中心的语言.
主要方法:
- 在移植中使用的临床术语的定性分析.
- 审查器官分配政策及其依赖患者执法标签的情况.
- 检查健康的社会决定因素对患者结果和获得护理的影响.
主要成果:
- 像"不合规"这样的非描述性标签是主观的,无法捕捉影响患者遵守的复杂情况.
- 这些标签导致了获得器官移植的重大障碍,不成比例地影响了弱势群体.
- 医疗保险覆盖不足是药物不服药的直接原因,导致全移植失败和随后的"不合规"标签.
结论:
- 在移植中延续非描述性语言限制了获得护理的机会,并引入了对器官分配决定的不当主观性.
- 移植委员会必须采用全面的记录实践,准确反映患者的情况.
- 给弱势群体发声和使用精确的语言对于促进移植中的健康公平至关重要.
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