Canada: Presumed Consent Misguided but Misinformation Unhelpful
By Marc Beuttler
Dr. Stephen Beed, professor of medicine and critical care physician at Dalhousie University, responded yesterday to the growing debate on presumed consent policy in organ donation.After Nova Scotia’s health minister recently broached the topic in an effort to improve organ donation rates, Jaquelyn Shaw, a health researcher in Halifax, responded with an inflammatory piece on presumed consent that was “rife with factual errors”, according to Dr. Stephen Beed.
Beed claims that, while he agrees with Shaw’s concerns on presumed consent, she distorts the context of organ donation in Canada. Ms. Shaw called into question the criteria for neurological death established in Canada in 2003. Contrary to Shaw’s claim that the new assessment with a focus on brain-stem function is a more lax criterion, these standards of declaring brain death are an extremely involved process. The 2003 guidelines aim to confirm that the parts of the brain controlling “consciousness, movement and sensation have ceased to function”. It requires two clinicians to agree that the patient is dead, and thus expends more energy than other less intensive methods to declare death.
Though Dr. Beed’s defends the 2003 brain death criteria and seeks to correct misinformation regarding organ donation, he maintains that the move towards a system of presumed consent is not appropriate. The idea of organ donation as a “private, personalized and comprehensive dialogue” is necessary to respect the patient and the family involved in such a decision. Dr. Beed asserts that presumed consent would not adequately respect these important stepping-stones to dealing with death.
