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Organ donation

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The College of Physicians calls for improving organ donation procedures in Quebec before adopting the principle of presumption of consent.

  • Véronique Prince (View profile)Véronique Prince< /li>

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Consultations on the establishment of the presumption of consent for organ donation begin Tuesday in the National Assembly. If parliamentarians are delighted with the progress of the file, the testimony of the College of Physicians of Quebec risks having the effect of a cold shower.

Presumed consent seems an obvious solution to save more lives. Each potential donor agrees in advance that their organs or tissues will be transplanted in the event of death.

Although it does not disagree with this principle, the College of Physicians raises caveats in a memorandum sent to parliamentarians.

According to the ;professional order, the adoption of the bill does not guarantee an increase in the number of donations. It is first necessary, says the College, to put in place organizational measures to improve the organ and tissue donation system in Quebec. In 2022, the show Enquête reported failures on this subject.

For example, explains the College, the current organization of the health network makes the availability of operating rooms uncertain at the time of removal or transplantation.

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It happens that the deceased must be kept alive artificially for several days while waiting for the sample to be taken. Meanwhile, because he occupies a bed in the intensive care unit, some doctors say he may deprive another patient of a spot. We report open conflicts between caregivers, we can read in the memoir.

The College of Physicians maintains that this situation leads to competition between doctors for beds in the intensive care unit, operating theaters and clinical resources.

Before adopting the presumption of consent for organ donation, he asks Quebec to put in place guidelines to develop a protocol for prioritizing donor cases, as well as all other urgent cases.

In fact, doctors must argue to determine whether a deceased patient, whose organs are intended to save a life or improve someone's existence, should take precedence for an intensive care bed or access to the operating room. on a patient victim of a serious road accident whose life is in danger. It seems that, most of the time, the trauma victim wins.

A quote from Dr. Mauril Gaudreault, president of the College of Physicians of Quebec

The phase during which the deceased person is kept alive artificially can last several days. Since the public is little informed about organ donation procedures, bereaved relatives sometimes decide to no longer authorize the organ donation so as not to delay the funeral.

Not only does the College of Physicians suggest optimizing the collection mechanics to reduce the delay, but it calls for the establishment of funded teams dedicated to donations in health establishments 24 hours a day, 7 days a week , to identify potential donors.

Although there are already three methods to consent to organ donation after death, the procedure is not not simple.

Registration in the RAMQ register requires numerous steps, including creating a ClicSÉQUR account and sending a form by mail.

The Register of consents to organ and tissue donation of the Chambre des notaires du Québec is only accessible to people who do business with notaries.

Finally, signing the sticker on the back of the health insurance card does not solve everything, since it may not be accessible at the time of death.

What's more, the multiplication of registers complicates things for nursing staff, already in the presence of the great influence exerted by relatives who can disregard the existence of clear consent, explains the College doctors in his memoir.

Indeed, despite the presumed consent of a deceased person, relatives can exercise a veto. This is why the professional order is calling for the establishment of a single register of consent or refusal. He is of the opinion that this step is necessary and prior to the adoption of the bill.

The College also believes that it is necessary to first analyze the results of Nova Scotia, which became the first jurisdiction in North America to establish, in January 2021, a regime based on presumed consent. He gives the examples of Chile and Brazil, the latter country having experienced difficulties in this area.

I am not against, but I am not not for either! It is not enough! This is not the solution. If we have more organs, but we are not better organized to transplant them, it will be a major disappointment for the people who agreed to donate their organs and for their families, summarizes Dr. Mauril Gaudreault, president of the College of Physicians of Quebec.

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