Allard Julie, Ballesteros Fabian, Fortin Marie-Chantal
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.
BMC Med Ethics. 2021 Mar 4;22(1):23. doi: 10.1186/s12910-021-00594-7.
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.
自2015年12月起，在魁北克省，医疗协助死亡（MAID）已合法化；自2016年7月起，在加拿大其他地区也已合法化。从那时起，已有60多人在医疗协助死亡后捐赠了他们的器官。此类捐赠引发了一些伦理问题，包括对患者自主权的尊重、选择医疗协助死亡的潜在压力、向潜在捐赠者提供的信息、在此背景下定向捐赠的可接受性以及捐赠导致死亡的可能性。本研究的目的是探讨魁北克专业人员对医疗协助死亡后器官捐赠相关伦理问题的看法。
我们对21名参与器官捐赠的医疗保健专业人员进行了半定向访谈，这些人员包括重症监护医生和重症监护护士、手术室护士、器官捐赠护士及协调员。
为了尊重患者的自主权，参与者都赞成医疗协助死亡后的器官捐赠。他们还赞成告知所有潜在捐赠者捐赠器官的可能性。他们强调在评估过程中评估捐赠者要求医疗协助死亡的原因的重要性。他们在定向捐赠、医疗协助死亡前的活体捐赠以及捐赠导致死亡的问题上存在分歧。
基于尊重捐赠者自主权的原则，医疗协助死亡后的器官捐赠在参与者中得到了广泛接受。本研究的结果仅提供了魁北克参与器官捐赠的医疗保健专业人员的观点。未来需要开展研究，以收集其他利益相关者对这一问题的看法，以及患者和家属在医疗协助死亡后器官捐赠的经历。
