Abstract
BackgroundMedical 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.MethodsWe 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.ResultsThe 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.ConclusionOrgan 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.
Highlights
Medical assistance in dying (MAID) has been legal in Québec since December 2015 and in the rest of Canada since July 2016
Even though organ donation after MAID is already performed in Belgium, the Netherlands and Canada, there is no report on the perspectives of health care professionals (HCPs) involved in organ donation
The interviews took place between November 2016 and February 2018 with HCPs practising in two hospitals selected for their key roles in organ donation and/or transplantation, namely Centre hospitalier de l’Université de Montréal (Saint-Luc and Notre-Dame sites) and Hôpital du Sacré-Coeur de Montréal, and with organ donation coordinators working for Transplant Québec, Québec’s organ donation organization (ODO)
Summary
Medical assistance in dying (MAID) has been legal in Québec since December 2015 and in the rest of Canada since July 2016. 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. In the Canadian province of Québec, medical aid in dying (MAID) has been legal since December 6, 2015 and consists of the administration of a medication by a physician to patients who meet certain conditions, including capacity to consent, unbearable suffering, serious and incurable illness, and being at the end of life [1]. The objective of our study was to explore Québec professionals’ perspectives on the ethical issues related to organ donation after MAID
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