Challenges facing Indigenous transplant patients living in Canada: exploring equity and utility in organ transplantation decision-making

ABSTRACT

Indigenous peoples in Canada and in the Circumpolar North face a higher disease burden leading to end-stage organ failure and face geographic and systemic barriers to accessing health-care services, including those for end-stage organ failure and organ donation and transplantation (ODT). To address these issues, I present a think tank model used in Saskatchewan, Canada, which focused on ODT and recommended research and policy changes that address inequitable Indigenous access to ODT, most specifically in northern and remote regions. Over the past three years, think tank members, comprised of Indigenous cultural leaders, elders, and persons with lived experience in ODT, and complemented by medical and advocacy exports, have highlighted equity and utility issues as key concerns, and discussed ways in which these issues can be addressed. Recommendations include culturally-safe methods for documenting and tracking Indigenous identity, development of training to address culturally specific needs, and additional funding to support Indigenous transplant donors and recipients.

KEYWORDS:

• Indigenous
• First Nations
• Métis
• Inuit
• organ donation
• organ transplant
• equity
• utility
• think tank
• Canada
• Circumpolar North

Acknowledgements

I would like to recognize current and past members of the First Nations and Métis Organ Donation and Transplantation Network for their contributions. I would also like to acknowledge the research staff who have provided support for the Network: Rhonda Taillon, Fleur Macqueen Smith, and Warrick Baijius and students Aden Tournier and Jacqueline Smith.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The views expressed in this article are those of the author and do not represent an official position of the University of Saskatchewan or the funders.

Additional information

Funding

The work was supported by the Royal University Hospital Foundation Research Grant; and the Saskatchewan Health Research Foundation and Saskatchewan Centre for Patient-Oriented Research Sprout Grant. Additional incidental funding support has been received from Canadian Blood Services and the Canadian Donation and Transplantation Research Network.