Québec health care professionals' perspectives on organ donation after medical assistance in dying.

Donation after cardiac death Medical assistance in dying Organ donation Professionals’ perspectives Qualitative methods

Journal

BMC medical ethics
ISSN: 1472-6939
Titre abrégé: BMC Med Ethics
Pays: England
ID NLM: 101088680

Informations de publication

Date de publication:
04 03 2021
Historique:
received: 21 08 2020
accepted: 24 02 2021
entrez: 5 3 2021
pubmed: 6 3 2021
medline: 29 7 2021
Statut: epublish

Résumé

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. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 33663501
doi: 10.1186/s12910-021-00594-7
pii: 10.1186/s12910-021-00594-7
pmc: PMC7934363
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

23

Références

J R Army Med Corps. 2001 Oct;147(3):367-70
pubmed: 11766225
Transplantation. 2014 Aug 15;98(3):252-3
pubmed: 24825517
Can J Psychiatry. 2018 Jul;63(7):451-456
pubmed: 29635929
Transplantation. 2014 Aug 15;98(3):247-51
pubmed: 24825514
J Med Ethics. 2017 Sep;43(9):601-605
pubmed: 28031256
J Heart Lung Transplant. 2019 Feb;38(2):111-113
pubmed: 30197210
J Med Philos. 2020 Jan 10;45(1):42-60
pubmed: 31841139
Arch Dis Child. 2019 Sep;104(9):827-830
pubmed: 30154185
CMAJ. 2019 Jun 3;191(22):E604-E613
pubmed: 31160497
Bioethics. 2012 Jan;26(1):32-48
pubmed: 20459428
N Engl J Med. 2020 Feb 6;382(6):576-577
pubmed: 32023380
CMAJ. 2016 Oct 4;188(14):E337-E339
pubmed: 27328688
BMC Med Ethics. 2019 Apr 2;20(1):22
pubmed: 30940195
J Med Ethics. 2016 Aug;42(8):486-9
pubmed: 27012736
Curr Opin Psychiatry. 2017 Jan;30(1):26-30
pubmed: 27798486
Am J Transplant. 2016 Jul;16(7):1967-72
pubmed: 26842128

Auteurs

Julie Allard (J)

Bioethics Program, Department of Social and Preventive Medicine, École de Santé Publique de l'Université de Montréal, Montréal, Canada.
Canadian Donation and Transplantation Research Program, Edmonton, Canada.

Fabian Ballesteros (F)

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 (MC)

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.
Canadian Donation and Transplantation Research Program, Edmonton, Canada. marie-chantal.fortin.chum@ssss.gouv.qc.ca.
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.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH