Center for Clinical Ethics, Department of Biotechnologies and Life Sciences, University of Insubria, Varese, Italy.
Department of Human Sciences, Innovation and Territory, University of Insubria, Como, Italy.
Transpl Int. 2023 Jul 31;36:11310. doi: 10.3389/ti.2023.11310. eCollection 2023.
International evidence shows variation in organ donation and transplantation (ODT) based upon a range of patient characteristics. What is less well understood is the impact of patient "ethnicity/race/immigration background," as these terms are defined and intended differently across countries. We also know that these characteristics do not operate in isolation but intersect with a range of factors. In this paper, we propose a framework that seeks to clarify the definition of the key terms "ethnicity/race/migrant" and to review how these communities are operationalized across European studies about inequities in ODT. Further, patients and the public wish to see Equality Diversity Inclusion (EDI) approaches in their everyday lives, not just in relation to ODT. We propose a 'care pathway/whole-systems' approach to ODT encompassing culturally competent public health interventions for a) the prevention and management of chronic diseases, b) improvements in public engagement for the promotion of the culture of ODT and enhancements in end-of-life care, through to c) enhanced likelihood of successful transplant among migrant/ethnic minority communities. Our framework recognizes that if we truly wish to take an EDI approach to ODT, we need to adopt a more social, human and holistic approach to examining questions around patient ethnicity.
国际证据表明，器官捐赠和移植（ODT）的情况因一系列患者特征而异。人们对患者“族裔/种族/移民背景”的影响了解较少，因为这些术语在不同国家的定义和意图不同。我们也知道，这些特征并非孤立存在，而是与一系列因素相互交织。在本文中，我们提出了一个框架，旨在澄清“族裔/种族/移民”等关键术语的定义，并审查这些社区在欧洲关于 ODT 不平等的研究中是如何运作的。此外，患者和公众希望在日常生活中看到平等多样性包容（EDI）方法，而不仅仅是与 ODT 相关的方法。我们提出了一种 ODT 的“护理途径/整体系统”方法，包括针对以下方面的文化能力公共卫生干预措施：(a) 预防和管理慢性疾病，(b) 提高公众对 ODT 文化的参与度，以及在临终关怀方面的提升，直至(c) 提高少数民族/族裔移民社区成功移植的可能性。我们的框架认识到，如果我们真的希望对 ODT 采取 EDI 方法，我们需要采取更具社会、人文和整体的方法来研究患者族裔相关问题。
