Fri. Mar 1st, 2024

R&eacute ;reluctance to presumed consent for organ donation

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The creation of a single platform to consent or refuse organ donation is requested by various experts.

The Canadian Press< p class="StyledBodyHtmlParagraph-sc-48221190-4 hnvfyV">The College of Physicians of Quebec (CMQ) and the Federation of Specialist Physicians of Quebec (FMSQ) are not very enthusiastic about the idea of ​​implementing quickly the presumed consent to organ donation.

Parliamentarians are currently analyzing the possibility of setting up a system where deceased people would no longer have to consent to organ donation. It would rather be those who refuse to have proof supporting their decision.

According to the speakers from the CMQ and the FMSQ, presumed consent would not guarantee an improvement in organ donation to Quebec.

Like other experts, they believe that a multitude of solutions are needed, including raising awareness and informing the public about organ donation , so that he adheres to the presumed consent. Otherwise, this could break citizens' confidence in the donation process, several doctors warned in a parliamentary committee on Wednesday.

For the College, presumed consent is not central to the increase in the number of organ and tissue donations, declared Dr. Mauril Gaudreault, president of the CMQ.

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He clarified that a larger pool of donors does not necessarily translate into an increase in the number of donations.

And even if presumed consent led to an increase in the number of potential donors, it would not mean that the number of organs available and transplanted would increase. And there is a risk of removing more organs than can be transplanted: the risk of wasting organs. We don't have that luxury.

The FMSQ was of the same opinion. Our view is that changing the consent model is not a successful strategy. […] The proposal to migrate to a system of implied or presumed consent, although it may seem attractive, is in reality more complex and potentially problematic, said Dr. Vincent Oliva, president of the FMSQ.

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Dr Vincent Oliva, president of the Federation of Specialist Physicians of Quebec

He said that the shortage of staff, difficulties in accessing the operating room and the lack of beds for patients are challenges that have major repercussions across the entire donation ecosystem.

Dr. Oliva related that an ophthalmologist told him that he receives a lot of donated corneas, but that he was not able to transplant them due to a lack of capacity and infrastructure.

There are donors. […] The bottleneck is really doing the transplants of the organs presented to us.

A quote from Dr. Vincent Oliva, president of the FMSQ

< p class="StyledBodyHtmlParagraph-sc-48221190-4 hnvfyV">The president of the CMQ indicated that the organization of the network makes the availability of intensive care beds and operating rooms uncertain at the time of removal or transplantation of organs or tissues from a Don.

This creates tension within medical teams, he said. Doctors compete for intensive care beds to keep an identified donor patient alive for a few days, or any other trauma patient whose life is in danger. p>Open in full screen mode

Mauril Gaudreault, president of the College of Physicians of Quebec

Dr. Gaudreault believes that problems of access to beds and operating rooms must be resolved upstream before changing the consent system. For us, this is not enough; In our opinion, this will not work. The risks of failure are greater if we only go with presumed consent. It's not that we don't agree with that, it's that it's not enough, he adds.

He proposed that a priority protocol for donor cases be developed and that guidelines be established to govern the x27;access to the operating room.

For her part, Me Catherine Claveau, President of Quebec, affirms that the Quebec population must first fully understand the organ donation process and the changes to the consent system, if applicable.

If we change the law to create a presumption, it really takes a campaign of #x27;information and awareness.

A quote from Me Catherine Claveau, President of Quebec

According to her, the Quebec Bar wishes to work with elected officials to see how to improve the situation. If presumed consent were implemented, the family would have the final say on organ donation, regardless of whether the deceased person signed their health insurance card. This is already the case at present.

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Me Catherine Claveau is President of Quebec.

For this reason, Transplant Québec emphasizes the importance of talking about your wishes with your loved ones. In recent years, the discussion in Quebec has mainly focused on signing the donor card. But we must go one step further, declared the general director of Transplant Québec, Martine Bouchard.

She recalls the importance of discussing one's wishes with one's family and partners and of saying that one would like to see oneself. they are respected in the event of a death.

The creation of a single platform to consent to organ donation or to refuse it is requested by the various experts heard by the parliamentary commission aiming to study ways to facilitate organ or tissue donation.

Currently, there are three ways to make your intentions known regarding organ donation in Quebec: by means of the organ donation card; health insurance, the Régie de l'assurance santé du Québec (RAMQ) and the Chambre des notaires.

All of the experts heard on Tuesday and Wednesday argued that it was necessary for the government to set up a single window, accessible 24 hours a day, and make it user-friendly.

This would facilitate the task of indicating consent or refusal for the population, but also for health professionals who must validate the status of the person died.

In other territories, there are registers which are online, which are accessible , who do not ask that we receive a paper. It's quite simple.

A quote from Dr. Prosanto Chaudhury, medical director at Transplant Québec

He said that in the United States, people can consent to organ donation from their cell phones thanks to the non-profit organization Donnate Life. He believes that Quebec has the same technologies that would make it possible to launch a universal registry of this type relatively quickly.

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Dr Prosanto Chaudhury is the medical director of Transplant Québec.

Me Mélanie Bourassa Forcier, full professor at the University of Sherbrooke, where she directs the health law and policy programs, proposed that elected officials consider adding certain options, for example the possibility of giving certain organs only.

Me Nicholas Hébert-Gauthier, lawyer at Bélanger Sauvé, gave the example of the heart, which is often a sensitive organ for certain communities.

We need to think about different modalities that could help increase individuals' confidence in organ donation, mentioned Ms. Bourassa Forcier.

According to her, it is essential to ensure that consent or refusal is known to every Quebecer, but that there is no has no empty box.

The general director of Transplant Québec, Martine Bouchard, indicated that the rate of donors per million inhabitants was 16 .7 in Quebec, the Canadian average being 19.3.

If we look at the number of donors per million inhabitants, we are at the back of the pack compared to our neighbors [in Canada] or even other countries. We were once very successful and we are no longer.

We were overtaken for all kinds of reasons: the the fact that we do not have a law, the fact that other territories have granted financial resources to the issue that are really greater than what we have here in Quebec, listed Ms. Bouchard.

Dr. Prosanto Chaudhury argued that more efficient provinces and countries often have legislation that designates a donation and transplantation agency with the necessary powers to assume his role. That an organization dedicated to overseeing the entire process of organ donation in Quebec be designated by the government is one of the key demands of Transplant Québec.

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