Under a new directive, patients who have not been vaccinated against COVID-19 will no longer be eligible for a lung transplant in Quebec. A decision that dramatically affects a 36-year-old Quebecer with cystic fibrosis.
Since the beginning of October, vaccination against COVID-19 has become a “criterion of eligibility for a lung transplant”, confirmed the Center hospitalier de l’Université de Montréal (CHUM) at To have to this week.
“The increased risks of rejection and complications, coupled with high mortality rates – of 25 to 30% – of patients infected with COVID-19 after lung transplantation, are at the heart of this difficult decision-making, including the The primary objective is to maximize the chances of a successful transplant, ”CHUM spokesperson Andrée-Anne Toussaint indicated by email.
Only lung transplantation is covered by this directive, which does not affect other organ transplants (heart, liver, pancreas, etc.).
In Quebec, the CHUM is the only hospital to perform lung transplants. Its spokesperson points out that it is not the only establishment in Canada to have imposed such a rule, since Toronto recently made the same decision for the most critical transplants.
Joanie Dupuis, 36, was recently advised that she was no longer eligible for a lung transplant because she was not vaccinated. She says she recently learned that she was eighth on the waiting list. “A pivot nurse came to see me. She told me they were gonna put me in stand-by until I got the vaccine, ”she explains. Mme Dupuis has suffered from cystic fibrosis since she was very young. She has been hospitalized since September 18 for a routine check-up related to her illness.
If she refuses to be vaccinated, it is because she was very ill after receiving the H1N1 flu vaccine a few years ago, she says. She adds that during her childhood, other vaccines temporarily paralyzed her arm and caused additional breathing problems. And that this gave birth to a sickly fear of vaccines in her. “I feel like I’m fighting the whole system, but I already have enough stress with the transplant itself,” she says.
Because her partner is not vaccinated either, he cannot visit her in the hospital. “I find myself all alone with my anxieties,” she says.
To each his chance
On October 19, Joanie Dupuis told her story during an online exchange between Conservative leader Éric Duhaime and his supporters. She later gave an interview on the subject to the media Rebel News, which posted a petition in support of her. Rebel News campaigns for various causes, such as the abolition of the vaccine passport and Canada’s withdrawal from the World Health Organization (WHO).
Mme Dupuis affirms to To have to not to be an anti-vaccine campaigner, adding that she sees herself more as “pro-choice”. “What I regret is that it is not on a case-by-case basis. I find it a bit special, she said. A person who has smoked all their life is going to be transplanted anyway. Everyone also has the right to have their chance. “
Does her fear of the vaccine justify risking her life? She replies that her fear “runs deep”. “Every time I think about it, I have extreme anxiety. Doctors, she adds, are trying to “get her to take the vaccine,” but they have not convinced her that it is in her best interests.
The patient insists, however, that she is “very well treated” in the hospital for her illness. “Doctors are dedicated. I have a fantastic team. It is not them that I want to criticize, but the rules. “
At the CHUM, it is stated that “each decision is made on the basis of the patient’s complete medical condition, to ensure the best chances of success for the transplant”.
Last year, 69 people received a lung transplant in Quebec. Since Mme Dupuis was at 8e rank, it can be assumed that she had a good chance of receiving a new lung in the coming months.
An ethical question
This event comes nearly two weeks after the head of the intensive care unit at Maisonneuve-Rosemont hospital, François Marquis, caused debate by declaring on the show Our 20’s that we could consider prioritizing double vaccinated people for non-emergency operations.
Asked Wednesday about the presence of an ethics committee in decision-making on transplants, the CHUM said that decisions were made by “transplant program” and “by establishment”.
“The decision to require vaccination against COVID-19 is in line with the reflections carried out by the Canadian Society of Transplantation”, also specified the spokesperson.
Joined by The duty, Transplant Quebec, which coordinates organ donation in Quebec, had no comments to make on the new directive. “We manage the waiting list, but each program is responsible for putting its patients on the list. It is up to them to choose the status of their patients on the list, ”indicated his spokesperson, Annie-Carole Martel.
For its part, the College of Physicians indicates that it was not consulted with regard to this directive and that it “will take the time to analyze all the facets of this question”.
According to the expert in clinical ethics at the University of Montreal Marie-Ève Bouthillier, the stake in this story is to know the doctors have “clinical reasons” not to proceed to the transplant on a patient. “If the answer is yes, it may be justified not to donate a rare organ to a person who might not benefit from it,” she explains. “The line not to cross is if there are any considerations other than clinical that motivate the decision. “