Prov­ince weighs on­line reg­istry for or­gan donors

PressReader - LStep Channel - Prov­ince weighs on­line reg­istry for or­gan donors
The prov­ince is look­ing into the pos­si­bil­ity of an on­line or­gan donor reg­istry, but says it has no time­line on when a de­ci­sion might be made to move ahead with one or not.“Any­thing that we would roll out would need to be easy to use,” said Luke Jackiw, direc­tor of hos­pi­tals and spe­cial­ized ser­vices with the acute and emer­gency ser­vices branch for the Min­istry of Health.Jackiw said the min­istry is do­ing “pre­lim­i­nary work” to as­sess op­por­tu­ni­ties to im­ple­ment a donor reg­istry, but no de­ci­sions have been made.“The most im­por­tant thing about that reg­istry is get­ting that in­for­ma­tion in the hands of health-care providers at the point of care when a de­ci­sion is re­quired,” he said. “So we need to work within our Saskatchewan-based IT sys­tems to en­sure that hap­pens.”Ad­vo­cates of on­line or­gan donor reg­istries say the ease with which a per­son can reg­is­ter would boost do­na­tion rates. Other coun­tries use an opt-out, or pre­sumed con­sent, model to the same end.Spain, Croa­tia and Por­tu­gal all have pre­sumed con­sent sys­tems and do­na­tion rates are higher than 25 donors per mil­lion pop­u­la­tion.In 2017, Saskatchewan’s rate of or­gan and tis­sue do­na­tion from de­ceased donors was 14.6 donors per mil­lion pop­u­la­tion, com­pared to 12.2 in 2016.In a 2016 in­ter­view, for­mer premier Brad Wall ex­pressed his per­sonal views that if it was pos­si­ble to have pre­sumed con­sent that’s “con­sis­tent with the rights of Cana­di­ans” that it would be a great thing for Saskatchewan to lead the coun­try in.But a com­mit­tee formed at the re­quest of for­mer health min­is­ter Dustin Dun­can in May 2016 to look into ways to boost the prov­ince’s or­gan do­na­tion rate did not rec­om­mend pre­sumed con­sent, say­ing im­ple­men­ta­tion of such a sys­tem would likely be chal­lenged in the courts.That mes­sage stands to­day. “Any de­ci­sions re­gard­ing opt-out or a pre­sumed con­sent model are on hold,” said Jackiw. “We’re fo­cus­ing our ef­forts on the im­prove­ments noted in the 2017 speech from the throne.”The speech, made on Oct. 25, 2017, out­lined four main strate­gies to help improve the no­to­ri­ously low or­gan do­na­tion rates in the prov­ince.The gov­ern­ment in­vested $500,000 to­ward im­ple­ment­ing a donor physi­cian/nurse co-or­di­na­tor model, ex­pand­ing the do­na­tion af­ter car­dio-cir­cu­la­tory death (DCD) pro­gram, im­ple­ment­ing a rou­tine no­ti­fi­ca­tion of in-hospi­tal deaths to the or­gan do­na­tion pro­gram and in­creas­ing pub­lic aware­ness.Saskatchewan saw three DCD dona­tions in 2018, which Jackiw cred­its to the ex­pan­sion of the DCD pro­gram and four donor physi­cians were hired in ad­di­tion to reg­is­tered nurse co-or­di­na­tors to sup­port donors and their fam­i­lies.(DCD hap­pens when a donor who has suf­fered “dev­as­tat­ing and ir­re­versible brain in­jury” and may be near death but does not meet the for­mal brain death cri­te­ria, ac­cord­ing to Jackiw. In th­ese cases the fam­ily has de­cided to with­draw care and it’s when the pa­tient’s heart stops beat­ing that the or­gans are then re­cov­ered.)Last spring, the min­istry — in part­ner­ship with the Saskatchewan Health Au­thor­ity (SHA) — launched a four-week mul­ti­me­dia aware­ness cam­paign that was rolled out over so­cial me­dia and in movie the­atres, health-care fa­cil­i­ties and lo­cal bars and restau­rants.“It was im­por­tant and still is im­por­tant to get that mes­sage out there,” said Jackiw. “The more we can keep or­gan do­na­tion at the fore­front, the more con­ver­sa­tions peo­ple have with their fam­i­lies and the higher the like­li­hood of a do­na­tion oc­cur­ring down the road.”Fi­nal num­bers aren’t avail­able for 2018, but Jackiw said it looks as if the de­ceased do­na­tion rate ap­pears to be sim­i­lar to that of 2017.For res­i­dents con­cerned about do­na­tion rates in Saskatchewan and are con­sid­er­ing mov­ing to a prov­ince with higher rates, Jackiw pointed to­ward na­tional ef­forts — like the Cana­dian Blood Ser­vices kid­ney-paired donor ex­change pro­gram — to pro­vide equal ac­cess to all Cana­di­ans.“When a do­na­tion does oc­cur ... there is ev­ery at­tempt to share ev­ery sin­gle one of those or­gans with pa­tients and en­sure they’re go­ing to the pa­tient with the high­est needs,” he said.As far as an on­line reg­istry, Jackiw says that’s only part of the puz­zle be­cause in the end, fam­ily mem­bers or next of kin have the fi­nal say.“I think it’s an im­por­tant tool to start the con­ver­sa­tion, but the most im­por­tant part about that is that con­ver­sa­tion with your fam­ily,” said Jackiw.“It doesn’t mat­ter if you have a reg­is­tered in­ten­tion ... be­cause in that mo­ment health-care providers look to a pa­tient’s fam­ily, look to a pa­tient’s next of kin, for di­rec­tion for what to do.”

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