Who will live? Who will die?

            The follow day, July 21^st, Taylor and I were invited to observe a multidisciplinary meeting within Grute Skoor’s renal unit.  We met up with the renal unit social worker and two Western Cape university social work interns.  He quickly explained that we were about to observe the meeting held between doctors, staff, social workers, and interns about the status of a patient.  The social worker then ushered us into a small meeting room with about 30 other professionals. 

            As the room filled, the room became quiet and the head doctor requested for the meeting to begin.  One by one the group listened to presentations on the patient’s medical history, current status, and the psycho-social prospective.  After each of the presentations, the group decided whether to accept or deny the patients into the dialysis program and subsequently the transplant list or denied.  As explained, the patients are categorized as either Category 1, 2, or 3.  Depending on whether the patient is category 1, 2, or 3 determines whether or not he or she receives treatment.  Many times the social worker’s assessment is the tiebreaker that determines whether the patient in accepted into the program. 

            By the end of the meeting and debrief with the social worker, Taylor and I reflected on the system of categories and what we had just witnessed.  As we looked at our notes, we realized that two patients were accepted into the program, two were placed on the waiting list, and three were not accepted due to their category 3 status.  We left the hospital with the knowledge that we were apart of the meeting that decided whether seven people were going to live or die.