Provincial required referral legislation of potential deceased donor to organ donation agency by hospital/physician | |
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BC | 3(1) A facility must notify BC Transplant Society immediately in the event of death or impending death of a patient 75 yr or younger in its care. 5(1) If the facility has given a notification under section 3 and has not been advised of a determination of the existence of a medical or other condition that will make the tissue of the patient unsuitable for use in another person, the facility must immediately search the registry to determine whether a decision record exists for that patient. |
AB | 7(1) When a person dies, the medical practitioner who makes the determination of death must consider and document in the patient record the medical suitability of the deceased person’s tissue or organs for transplantation. 7(2) If a medical practitioner determines that a person’s tissue or organs may be suitable for transplantation […], the medical practitioner must notify a donation organization, if any, in a manner satisfactory to the donation organization. |
SK | Silent |
MB | 4(1) Subject to the requirements and circumstances established under subsection 4.2(1), a designated facility must notify the required human tissue gift agency when (a) a patient at the facility dies; (b) a physician at the facility advises that the death of a person at the facility is imminent and inevitable; or (c) the facility receives a dead body. |
ON | 8.1(1) A designated facility shall notify the Network as soon as possible when a patient at the facility has died or a physician is of the opinion that the death of a patient at the facility is imminent by reason of injury or disease. (2) Despite subsection (1), a designated facility is not required to notify the Network if the Network has established requirements that set out circumstances in which notice is not required and those circumstances exist. |
QC | 204.1 When informed of the imminent or recent death of a potential organ or tissue donor, the director of professional services of an institution operating at a general and specialized hospital shall diligently (1) verify with one of the organizations that coordinate organ or tissue donations and are designated by the Minister under section 2.0.11 of the Act respecting the Régie de l’assurance maladie du Québec (chapter R-5) whether the potential donor’s consent for the post-mortem removal of organs or tissues is recorded in the consent registries established by the Ordre professionnel des notaires du Québec and the Régie de l’assurance maladie du Québec, to determine the donor’s last wishes expressed in this regard in accordance with the Civil Code; and (2) send to such an organization, if consent has been given, any necessary medical information concerning the potential donor and the organs or tissues that may be removed. The director of professional services is informed of the imminent or recent death of a potential organ or tissue donor in accordance with the procedure established by the institution. |
NS | Silent 17(1) When an individual dies, or in the opinion of a physician death is imminent, in a hospital, the hospital shall, as soon as possible, provide [prescribed information] to the organ donation program and, where so prescribed, to the tissue bank.* |
Methods
Assumptions and key considerations
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Discussions at the conference will be based on summaries of evidence prepared by the Steering Committee, the experience of practitioners, and Canadian leading practices.
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Developing expert consensus statements for potential organ donor ID&R does not dictate organ donation and transplant (ODT) practice, but provides a framework for a more consistent approach that can be adapted to regional/individual applications; individual ODT professionals will continue to make decisions regarding individual patients and families based on their unique circumstances.
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Existing legal and ethical frameworks in Canada served as a reference for discussions.
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Leading practice consensus statements pertaining to donor ID&R require thoughtful implementation strategies and must recognize the unique needs of different regions, programs, and HCPs.
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A paradigm and culture shift at multiple levels (HCP, intensive care units (ICUs), hospital administrators, professional societies, patients, the public, patient safety representatives, and governments) may be required to agree that missing a potential organ donor should be considered a critical (sentinel) safety event.
Consensus statements
Mission statement
Theme 1: Expectations of potential donors, recipients, and their families
Impact of failing to identify and refer a potential organ donor
Considerations
Considerations
Circumstances where identifying or referring a potential organ donor may be challenging
Theme 2: Donor ID&R: clinical and legal perspectives
Considerations
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defined as the formal process by which the healthcare team seeks to involve the ODO;
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based on fulfilling clinical triggers; and
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should not occur until NDD or after WLST decisions have been made.
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refers to a member of the healthcare team advising the ODO of the presence of a potential donor and may be an option prior to meeting referral criteria; and
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may also be initiated upon family requests for donation information.
Considerations
Considerations
Theme 3: Enhancing accountability: gaps and solutions
Considerations
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would require modifications to incorporate death audit data.
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Canadian Blood Services may have a role in facilitating electronic reporting and data collection from centres who do not use iTransplant.