Organ Donation After Death in Québec: Should Family Involvement on Consent Be Restricted?

Organ;Organ Donation;Organ Transplantation and Donation;Consent to Organ Donation;Family Consent;Double Consent;Family Overuling Consent;Organ Donors;Informed Consent: Presumed Consent

Bellavance, Sylvain

University:Havard University

Department:History

关键词: Organ;    Organ Donation;    Organ Transplantation and Donation;    Consent to Organ Donation;    Family Consent;    Double Consent;    Family Overuling Consent;    Organ Donors;    Informed Consent: Presumed Consent;   

Others  :  https://dash.harvard.edu/bitstream/handle/1/37365402/BELLAVANCE-DOCUMENT-2020.pdf?sequence=1&isAllowed=y

美国|英语

来源: Digital Access to Scholarship at Harvard

【 摘 要 】

At a time when organ transplantation has become one way to address many health problems, there are not enough organs available to meet demand and many persons are dying worldwide while awaiting a transplant. The province of Qubec faces the same challenges and efforts are made every year by Transplant Québec to get individuals to consent to organ donation after death.More than 40% of the population registered their wishes to donate in one of the two registries available in Québec, and even more expressed their consent for organ donation on their health insurance card, upon renewal. However, reality shows that their sole consent is not sufficient and family approval is requested for each organ donation, thereby amounting to a double consent and granting families a veto over the wishes of the deceased. An analysis of Transplant Québec’s Annual Reports, and of a specific set of data compiled for this thesis, reveals that 40 % of refusals to proceed with an organ referral are attributable to families’ objections and that their reasons for refusing is explained mainly by personal motives and not reasons associated with the deceased. It also reveals that 20% of family refusals concern a donor who had expressed a consent to organ donation, meaning that families overrode the wishes of donors in more than 40 cases of organ referrals in 2018, thereby causing the loss of available organs and, without doubt, costing lives. This thesis reviews various legal, ethical and practical arguments which support restricting family involvement on consent to organ donation in Québec and, when expressed, giving precedence to donors’ wishes. At a time when voices are calling for the introduction of a presumed consent system for deceased donor organ donation in Québec, we conclude that specific restrictions on family involvement are instead required and we propose potential solutions to consider.