Priority Setting in the Assessment for Kidney Transplant Candidacy: a Canadian Case Study
(English)Manuscript (preprint) (Other academic)
The benefits of kidney transplantation for treating kidney failure are well documented in terms of life expectancy, quality of life, and cost savings, making it the treatment of choice. It is however limited by the chronic shortage of kidneys. This study’s objective is to examine the fairness of the priority setting process underpinning the assessment for kidney transplant candidacy in one of Canada’s largest transplant programs at the Toronto General Hospital (TGH). This is done in reference to the Accountability for Reasonableness; a leading international framework in health care priority setting.
The study relies on three sources for data collection: semi structured interviews, process observation, and review of relevant documents.
The process underpinning the assessment for kidney transplantation is based on clusters of medical criteria reflecting the Canadian national consensus guidelines on eligibility for kidney transplantation. The process is permeated by ethical principles such as: maximizing benefit, equal treatment, and respect for autonomy; which are widely considered relevant in the distribution of scarce medical resources and in medical ethics generally. The criteria for assessment are well publicized and easily accessible while appeals through second opinions are well developed and supported. The process underpinning access to kidney transplantation at the TGH readily satisfies the conditions for fairness in references to the Accountability for Reasonableness framework.
Health Care Service and Management, Health Policy and Services and Health Economy
IdentifiersURN: urn:nbn:se:liu:diva-71311OAI: oai:DiVA.org:liu-71311DiVA: diva2:447221