Peticca Benjamin, Prudencio Tomas M, Robinson Samuel G, Karhadkar Sunil S
Department of Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA 19140, United States.
World J Nephrol. 2024 Mar 25;13(1):88967. doi: 10.5527/wjn.v13.i1.88967.
Non-descriptive and convenient labels are uninformative and unfairly project blame onto patients. The language clinicians use in the Electronic Medical Record, research, and clinical settings shapes biases and subsequent behaviors of all providers involved in the enterprise of transplantation. Terminology such as and serve as a reason for waitlist inactivation and limit access to life-saving transplantation. These labels fail to capture all the circumstances surrounding a patient's inability to follow their care regimen, trivialize social determinants of health variables, and bring unsubstantiated subjectivity into decisions regarding organ allocation. Furthermore, insufficient Medicare coverage has forced patients to ration or stop taking medication, leading to allograft failure and their subsequent diagnosis of . We argue that perpetuating non-descriptive language adds little substantive information, increases subjectivity to the organ allocation process, and plays a major role in reduced access to transplantation. For patients with existing barriers to care, such as racial/ethnic minorities, these effects may be even more drastic. Transplant committees must ensure thorough documentation to correctly encapsulate the entirety of a patient's position and give voice to an already vulnerable population.
非描述性且随意的标签缺乏信息，还会不公正地将责任归咎于患者。临床医生在电子病历、研究及临床环境中使用的语言会形成偏见，并影响移植事业中所有相关医护人员随后的行为。诸如“（此处原文缺失具体术语）”等术语成为等待名单停用的理由，并限制了获得挽救生命的移植手术的机会。这些标签未能涵盖患者无法遵循治疗方案的所有情况，轻视了健康变量的社会决定因素，并将未经证实的主观性引入器官分配决策中。此外，医疗保险覆盖不足迫使患者减少用药量或停止用药，导致同种异体移植失败以及随后被诊断为“（此处原文缺失具体诊断）”。我们认为，持续使用非描述性语言几乎没有增加实质性信息，增加了器官分配过程中的主观性，并在减少移植机会方面起到了主要作用。对于那些存在护理障碍的患者，如少数族裔，这些影响可能更为严重。移植委员会必须确保进行全面记录，以正确概括患者的整体情况，并为这个本就脆弱的群体发声。
