This discussion was very informative and interesting! Dr. Gardiner presented her research on how a provider’s perception and policies on BMI affect a patient’s eligibility for kidney transplantation. Study one explored provider attitudes for BMI as an indicator for eligibility while study two explored the role of BMI in determining eligibility for kidney transplantation. The results showed discrepancies between the provider’s perception and the policy statement on what an appropriate BMI should be. The policy benchmarks were lower than what the providers thought the BMI cutoff should be. Furthermore, there is a lack in educating those with a higher BMI on how to lose weight to meet the benchmarks and get a transplant.
Kidney disease is a very difficult condition to treat especially in regards to BMI. For one, when a patient is on dialysis, they’re discouraged to lose weight as it may hinder treatment. However, what should they do once they need to get a transplant in the long term but need to stay on dialysis in the long term? This puts the patient in a difficult position and could definitely affect them psychologically if they feel like they do not know what to do.
Something I wish the speaker could further discuss are the existing institutional power structures/beliefs that minorities may face that prevent them from getting transplant/treatments. She did mention that Caucasians might be more likely to receive a transplant from a living donor while minorities may not have someone healthy enough to donate within their social network and thus, that can be a reason why transplantation rates are higher for them. Another interesting part she mentioned was that while being on Medicaid/Medicare, most patients wouldn’t be able to get on a waiting list for transplantation until recently. She also mentioned how in Spain, it is assumed that people will donate their organs after death since they see it as a social good while we value autonomy in the USA. I wish more information could be given on these topics but it also seems like this research is still in its preliminary stages and we still have a lot to learn.
Jessica,
I agree that more studies need to mention the structures / beliefs that minorities may face that prevent them from getting transplant/treatments.
I think we both can agree that more research needs to be done in this field in order to better the healthcare system that our country operates.
I definitely agree that it would be interesting to learn more about structures that prevent minorities from getting transplants and cultural differences that result in greater availability of transplants abroad. These topics illustrate that in addition to changing center policies, there is a need to address racial, ethnic and cultural barriers to treatment.
I was also really intrigued when she talked about the differences in how Spain approaches organ transplantation. The fact that they have an opt-out rather than an opt-in system for organ donation means they probably have a much larger pool of potential donors. I don’t think that the US’s emphasis on autonomy has to be mutually exclusive from an opt-out system; I think we should have an opt-out system that makes it easy for people who don’t want to be donors to choose not to, while everyone else who is indifferent or wants to donate is automatically in the position to do so. This could help so much with the short supply of organs, and it bothers me that it’s not a part of our system.