How important is social support in determining patients’ suitability for transplantation? Results from a National Survey of Transplant Clinicians

Journal of Medical Ethics 44 (10):666-674 (2018)

Authors
Abstract
Background National guidelines require programmes use subjective assessments of social support when determining transplant suitability, despite limited evidence linking it to outcomes. We examined how transplant providers weigh the importance of social support for kidney transplantation compared with other factors, and variation by clinical role and personal beliefs. Methods The National survey of the American Society of Transplant Surgeons and the Society of Transplant Social Work in 2016. Using a discrete choice approach, respondents compared two hypothetical patient profiles and selected one for transplantation. Conditional logistic regression estimated the relative importance of each factor; results were stratified by clinical role and beliefs. Results Five hundred and eighy-four transplant providers completed the survey. Social support was the second most influential factor among transplant providers. Providers were most likely to choose a candidate who had social support, always adhered to a medical regimen, and had a 15 years life expectancy with transplant. Psychosocial providers were more influenced by adherence and quality of life compared with medical/surgical providers, who were more influenced by candidates' life expectancy with transplant. For providers concerned with avoiding organ waste, social support was the most influential factor, while it was the least influential for clinicians concerned with fairness. Conclusions Social support is highly influential in listing decisions and may exacerbate transplant disparities. Providers’ beliefs and reliance on social support in determining suitability vary considerably, raising concerns about transparency and justice.
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2017-104695
Options
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

Our Archive


Upload a copy of this paper     Check publisher's policy     Papers currently archived: 45,662
External links

Setup an account with your affiliations in order to access resources via your University's proxy server
Configure custom proxy (use this if your affiliation does not provide a proxy)
Through your library

References found in this work BETA

Why People Obey the Law.Tom R. Tyler - 1990 - Yale University Press.

Add more references

Citations of this work BETA

Diversity of Scholarship in Medical Ethics.Rosalind J. McDougall - 2018 - Journal of Medical Ethics 44 (10):655-656.
In Search of the Ideal Transplantation Candidate.Mark D. Fox & Ross D. McCauley - 2019 - American Journal of Bioethics 19 (11):31-32.

Add more citations

Similar books and articles

How Do Patients Know?Rebecca Kukla - 2007 - Hastings Center Report 37 (5):27-35.
Closing the Organ Gap: A Reciprocity-Based Social Contract Approach.Gil Siegal & Richard J. Bonnie - 2006 - Journal of Law, Medicine and Ethics 34 (2):415-423.
Transplantation Ethics: Old Questions, New Answers?Michael Devita, Mark P. Aulisio & Thomas May - 2001 - Cambridge Quarterly of Healthcare Ethics 10 (4):357-360.

Analytics

Added to PP index
2018-07-02

Total views
14 ( #611,972 of 2,280,720 )

Recent downloads (6 months)
5 ( #245,716 of 2,280,720 )

How can I increase my downloads?

Downloads

My notes

Sign in to use this feature