Registering as an organ donor in Quebec does not guarantee anything in the event of a death since relatives have the equivalent of a “vet” on this subject, reveal discussions at the Parliamentary Commission on the subject this week .
Parliamentarians are studying this week the possibility of implementing the “presumption of consent” for organ donations in Quebec. This system would ensure that it would be up to people who do not want to donate their organs to report this during their lifetime.
However, since Tuesday, several experts have come to tell elected officials that this would not necessarily increase the number of transplants since families have, in any case, the last word upon death in terms of organ donations.
Many have compared this to a sort of family “vet” including the Dr Frédérick D’Aragon, member of the coordinating physicians of Quebec and holder of the Justin Lefebvre Research Chair in organ donation.
Legally, the Civil Code protects the wishes of the deceased “except for compelling reasons”, which leaves a lot of room for interpretation, mentioned Transplant Québec.
However, in practice, health personnel always follow the wishes of their loved ones. And this, even if the criterion of “compelling reasons” in the Act had not been imposed to take into account their opinion, but rather the quality of the bodies, pointed out a representative of the Quebec Bar.
The question is very delicate. And it often arises at the worst moment in the lives of affected families. But at the same time, 80% of people believe that the family should not go against the wishes of the deceased person who has registered for organ donations, according to a survey cited by researcher Mélanie Bourassa Forcier of the Faculty of Law of the University of Sherbrooke.
Presumed consent not a priority
No expert has suggested going against the wishes of loved ones. But the discussion since Tuesday has focused in particular on the means to get more loved ones to say “yes”.
Several experts stressed that it was necessary to better train the staff called upon to approach families.
Sometimes, staff do not dare to ask relatives because they “assume” that the family is too “in shock”, argued the Dr Matthew John Weiss, medical director of organ donation at Transplant Québec. But it could be “wrong,” maybe the family would have said “yes,” he said.
Some have also suggested that health professionals be required to notify the presence of a potential donor in a register, or even that they have the obligation to suggest it to families. A large part of the deaths which open the door to donations “occur at unfavorable times”, underlined the Dr From Aragon. “On weekends, in the evening, during holidays”, when the staff present are not necessarily responsible for identifying candidates for organ donations.
The Dr D’Aragon recalled that only 1% of deaths “qualified” for donations “so the opportunity should not be missed.” »
Since Tuesday, Quebec has been described as a real dunce when it comes to organ donations. One after the other, the experts who appear before the Parliamentary Health Commission are calling for major changes, including a law to regulate the field, a simplified window for registering as a donor and a better structured organization to encourage donations and follow up.
The majority judges that presumed consent to organ donation should not be implemented in the short term and that this should first be the subject of an in-depth debate. Only the Quebec Bar has shown itself open to this avenue in the short term, but subject to certain conditions such as the establishment of a mandatory register in which people could clearly indicate their refusal, if any.
The Minister for Health Sonia Bélanger indicated that she intended to legislate on the issue and that she would rely on the work of the Commission to structure her bill. The holding of the parliamentary commission also results from the tabling in 2023 of a bill on this subject (173) by the liberal opposition MP André Fortin.