Julie Allard1,2, Fabian Ballesteros3, Marie-Chantal Fortin4,5,6. 1. Bioethics Program, Department of Social and Preventive Medicine, École de Santé Publique de l'Université de Montréal, Montréal, Canada. 2. Canadian Donation and Transplantation Research Program, Edmonton, Canada. 3. Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CHUM), 900, rue Saint-Denis, R12-418, Montréal, QC, H2X 0A9, Canada. 4. Bioethics Program, Department of Social and Preventive Medicine, École de Santé Publique de l'Université de Montréal, Montréal, Canada. marie-chantal.fortin.chum@ssss.gouv.qc.ca. 5. Canadian Donation and Transplantation Research Program, Edmonton, Canada. marie-chantal.fortin.chum@ssss.gouv.qc.ca. 6. Department of Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CHUM), 900, rue Saint-Denis, R12-418, Montréal, QC, H2X 0A9, Canada. marie-chantal.fortin.chum@ssss.gouv.qc.ca.
Abstract
BACKGROUND: Medical assistance in dying (MAID) has been legal in Québec since December 2015 and in the rest of Canada since July 2016. Since then, more than 60 people have donated their organs after MAID. Such donations raise ethical issues about respect of patients' autonomy, potential pressure to choose MAID, the information given to potential donors, the acceptability of directed donations in such a context and the possibility of death by donation. The objective of this study was to explore Québec professionals' perspectives on the ethical issues related to organ donation after MAID. METHODS: We conducted semi-directed interviews with 21 health care professionals involved in organ donation such as intensivists and intensive care nurses, operating room nurses, organ donation nurses and coordinators. RESULTS: The participants were all favourable to organ donation after MAID in order to respect patients' autonomy. They also favoured informing all potential donors of the possibility of donating organs. They highlighted the importance of assessing donors' reasons for requesting MAID during the assessment. They were divided on directed donation, living donation before MAID and death by donation. CONCLUSION: Organ donation after MAID was widely accepted among the participants, based on the principle of respect for the donor's autonomy. The findings of this study only provide the perspectives of Québec health care professionals involved in organ donation. Future studies are needed to gather other stakeholders' perspectives on this issue as well as patients' and families' experiences of organ donation after MAID.
BACKGROUND: Medical assistance in dying (MAID) has been legal in Québec since December 2015 and in the rest of Canada since July 2016. Since then, more than 60 people have donated their organs after MAID. Such donations raise ethical issues about respect of patients' autonomy, potential pressure to choose MAID, the information given to potential donors, the acceptability of directed donations in such a context and the possibility of death by donation. The objective of this study was to explore Québec professionals' perspectives on the ethical issues related to organ donation after MAID. METHODS: We conducted semi-directed interviews with 21 health care professionals involved in organ donation such as intensivists and intensive care nurses, operating room nurses, organ donation nurses and coordinators. RESULTS: The participants were all favourable to organ donation after MAID in order to respect patients' autonomy. They also favoured informing all potential donors of the possibility of donating organs. They highlighted the importance of assessing donors' reasons for requesting MAID during the assessment. They were divided on directed donation, living donation before MAID and death by donation. CONCLUSION: Organ donation after MAID was widely accepted among the participants, based on the principle of respect for the donor's autonomy. The findings of this study only provide the perspectives of Québec health care professionals involved in organ donation. Future studies are needed to gather other stakeholders' perspectives on this issue as well as patients' and families' experiences of organ donation after MAID.
Entities:
Keywords:
Donation after cardiac death; Medical assistance in dying; Organ donation; Professionals’ perspectives; Qualitative methods
Authors: Jan A M Bollen; Rankie Ten Hoopen; Mark A H B M van der Hoeven; David Shaw; Joe Brierley; Dirk Ysebaert; L W Ernest van Heurn; Walther N K A van Mook Journal: Arch Dis Child Date: 2018-08-28 Impact factor: 3.791
Authors: Jan A M Bollen; David Shaw; Guido de Wert; Rankie Ten Hoopen; Dirk Ysebaert; Ernst van Heurn; Walther N K A van Mook Journal: J Heart Lung Transplant Date: 2018-07-27 Impact factor: 10.247