Medical Reparations Have Arrived

The Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing (UNOS) are implementing new policies to make skin color a crucial factor in who receives life-saving kidney transplants. {snip}

In the name of “equity,” UNOS and OPTN purport to be expanding black patients’ access to kidney transplants. They essentially claim that the longstanding system for such transplants is racist, pointing to how black patients make up 30 percent of the dialysis population and transplant wait list but receive a smaller fraction of kidney transplants.

{snip}

If racism doesn’t explain the discrepancy, what does? The list of reasons is extensive {snip} One is the advanced age and complex medical conditions of many black patients with diabetes-related kidney failure; many of these patients are also relatively satisfied with dialysis treatments and unwilling to undergo extensive evaluation for transplant suitability. Others include insufficient health literacy, concern about the surgical procedures associated with transplantation, and lack of a support system for post-operative patients—an especially important factor in transplant suitability. Black families are also less likely to supply kidney donors from relatives.

{snip}

{snip} Less accurate than the previous method, the new one lowers kidney-function assessment for black patients to the point that some who did not qualify for placement on the transplant list now meet the requirement. {snip}

OPTN isn’t just using this new assessment going forward. It is retroactively applying the new formula—potentially tracing back decades—to previous assessments of kidney function in black patients. Many black patients previously regarded as ineligible for the transplantation waitlist will now be listed, and some will even be moved ahead of others already on the waiting list. {snip}

{snip}

Five times as many whites as blacks donate kidneys, which means that many more whites enjoy this benefit. Activists therefore see it as racist, and they want OPTN to change its policies. The group is considering four proposals; all would eliminate prior donors’ waitlist priority and give them a mere 10 percent–15 percent improvement on their waitlist position. That would virtually eliminate the chance that a white patient might move ahead of a black patient on the wait list, even after he or she donates a kidney. And this policy, which OPTN expects to finalize before the end of this year, risks discouraging kidney donors as a whole. White people are being punished in the name of righting nonexistent wrongs, but patients of every race will suffer from this move.

{snip}