Health Professionalsʼ Perspectives On Gift-Exchange in Altruistic Unbalanced Paired Kidney Exchange and Kidney Paired Donation.
Bibliographic record
Abstract
Background: The gift exchange cycle is characterized by a triple set of norms: to give, receive and repay. This set of norms applies to living related kidney donation. Do new modalities of living organ donation such as kidney paired donation (KPD) and altruistic unbalanced paired kidney exchange (AUPKE) alter the gift relationship? The aim of this study is to examine how health professionals view the gift relationship in AUPKE and KPD. Methods: A total of 19 transplant professionals working in 4 Canadian transplant programs, and 19 non-transplant professionals (referring nephrologists and pre-dialysis nurses) working in 5 Quebec dialysis centres took part in semi-structured interviews between 11/2011 and 06/2013. The content of these interviews was analyzed using a qualitative data analysis method. Results:To give: Respondents mentioned that the principal motivation to donate in AUPKE would be altruistic, since the donor would help more individuals than in living related donation. Some professionals were concerned that the donor and recipient in AUPKE or KPD have no emotional relationship while others did not see this as problematic, since the gesture is the same, whether one donates to a stranger or a loved one. To receive: Respondents were divided on the issue of receiving a kidney from a loved one or stranger. For some, the priority was for the recipient to get a functioning kidney; others acknowledged the importance of receiving a kidney from a known donor because of the emotional relationship and knowledge of the donor's lifestyle. To repay: For many respondents, AUPKE or KPD would not alter the obligation to repay, since the recipient's gratitude would be the same, regardless of the donor. Also, AUPKE or KPD could mitigate the “tyranny of the gift” that can occur in living related donation. On the other hand, some respondents believed that being related to the donor could be an added incentive for recipients to adhere to their treatment regimens. Conclusion: The results of this study show that respondents were divided on how AUPKE and KPD could alter the gift exchange in living organ donation. With AUPKE and KPD, the kidney of a living donor becomes a public resource, just like the kidney of a deceased donor. This change in the nature of the gift could have an impact on policies and practices.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.029 | 0.026 |
| Scholarly communication | 0.009 | 0.004 |
| Open science | 0.001 | 0.010 |
| Research integrity | 0.006 | 0.007 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".