Department of Medicine, University of Alberta, 11-107 Clinical Sciences Building, Edmonton Alberta T6G2G3.
Nephrol Dial Transplant. 2010 Jul;25(7):2334-41. doi: 10.1093/ndt/gfq072. Epub 2010 Mar 5.
Clinical practice, policy and research, and the ethical bases upon which they are founded, should be systematically and transparently informed by both patient and professional values.
A discrete choice experiment was utilized to understand and quantify the preferences of 351 Canadian patients and healthcare providers in relation to ethically challenging aspects of the management of chronic kidney disease (CKD): procurement and allocation of organs for transplantation, end-of-life care discussions and decision making and the identities of those providing primary care.
Patients and health professionals had clear preferences for detailed prognostic information, early advance care planning, shared end-of-life decision making, coordinated models of care that enhance interaction and communication between primary and tertiary care and a more utilitarian approach of best match over first come, first served for allocating deceased donor kidneys. These data also suggest that the innovative strategies of non-directed anonymous donation and paired kidney exchange that are slowly being implemented internationally will be acceptable to both patients and healthcare providers.
Current models of CKD care do not consistently reflect the preferences or priorities of either health professionals or patients.
临床实践、政策和研究，以及它们所依据的伦理基础，应该系统地、透明地以患者和专业人员的价值观为依据。
采用离散选择实验的方法，了解和量化了 351 名加拿大患者和医疗保健提供者对慢性肾脏病（CKD）管理中具有伦理挑战性的方面的偏好：器官获取和分配用于移植、临终关怀讨论和决策以及提供初级保健的人员的身份。
患者和卫生专业人员对详细的预后信息、早期的预先护理计划、共同的临终决策、加强初级和三级保健之间互动和沟通的协调护理模式以及更实用的最佳匹配方法（优于先来先服务）分配已故供体肾脏有明确的偏好。这些数据还表明，国际上正在缓慢实施的非定向匿名捐赠和配对肾脏交换等创新策略将被患者和医疗保健提供者所接受。
目前的 CKD 护理模式并没有始终如一地反映出卫生专业人员或患者的偏好或优先事项。
