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It will take more than the publicity surrounding the case of Eugene Melnyk to close the current organ-donation gap, say those who study the issue.
Despite campaigns that have increased the numbers of organ donors in Ontario in recent years, patients continue to die every week while waiting for a transplant. About 500 people were on waiting lists for liver transplants in Canada in 2013. Eighty-six of them died while waiting.
Supporters have said they hoped Melnyk’s public experience will shine a light on the need for more organ donors. Melnyk, who has a rare blood type, went public with his need for a live liver donation after family and close friends were ruled out as suitable donors, and there was little hope of getting a liver from a deceased donor. He underwent a successful surgery Tuesday after finding a donor.
Officials with Ontario’s Trillium Gift of Life Network saw more than 3,000 online registrations the week Ottawa’s Hélène Campbell was on the Ellen DeGeneres Show in 2012. Campbell eventually received a double lung transplant.
The awareness raised by Melnyk’s plea for a live liver donor would also result in an uptick in registrations if all the people who came forward as potential donors registered to donate their organs when they die, said Ronnie Gavsie, president of Trillium.
But Gavsie said public awareness campaigns can have relatively short-term benefits and they alone aren’t enough to raise organ-donation levels to where they should be.
“These situations are not going to sustain registration at a high number, but they have a huge impact in educating very broadly.”
What is needed, she said, is a “new cultural norm” in which individuals and the health system all work toward dramatically increasing the numbers of organ donors.
Trillium says its goal is to have 51 per cent of the Ontario population registered as donors.
Ontario’s rate of organ donor registration — currently at about 26 per cent — is higher than that in much of the country, but Canada trails other nations, including the United States.
There are growing calls for changes, including a system of “presumed consent,” in which suitable organs are automatically donated unless a person has specifically opted out. Some are also calling for a change to the law to allow pilot projects in which donors’ families could be paid funeral expenses, for example. Currently, any exchange of money is illegal.
Udo Schuklenk, a bioethicist at Queen’s University, said he sees no reason to criticize Melnyk, as some have done, for using his platform to broadcast his desperate need.
“What is problematic isn’t so much this individual’s response. What is objectionable is a system that gives rise to such responses. . . . Much could be done to improve our current status quo.”
He suggested both an opt-out system for organ donations, as the country of Spain has, and, after study, a means to incentivize donating.
Maeghan Toews, a research associate with the Health Law Institute at the University of Alberta, recently gave a presentation on questioning some of the negative assumptions about financial incentives to increase organ donations. It is time, she said, to look more closely at the idea. Currently, even trying something on a pilot basis to see if it makes a difference is banned.
She said she would also like to see a presumed-consent system and more emphasis in hospitals to increase donor rates. Organ donations are vetoed by family members in as many as 10 per cent of people who have signed to consent to organ donation.
Gavsie noted that Ontario put changes in place a year ago that should increase actual donor rates, including publicly reporting hospital donation rates and trying to increase physicians’ engagement in the issue. Ontario also encourages people to discuss their wishes with their family to reduce the risk of family members vetoing donation.
Ontario Health Minister Dr. Eric Hoskins said, however, that there is no conclusive evidence the presumed-consent model leads to more donations. Some countries with the highest organ-donation rates use presumed consent and some don’t, he said. “Our focus as a province is on increasing the number of organ and tissue donors.”
Raising awareness about the need to donate and improving the ease of becoming a donor, he said, brought record numbers last year in Ontario. “It has never been easier to become a donor.”
Toews said she understands why people would take to media to try to find an organ donor, given the odds, but said she has concerns about those on waiting lists without prominent public profiles who can’t reach out in the same way.
“I think these cases raise concerns about whether we want to have an organ-allocation system where people with greater access are more likely to get one.”
Ontarians can register to donate their organs at BeADonor.ca
epaytne@ottawacitizen.com
查看原文...
Despite campaigns that have increased the numbers of organ donors in Ontario in recent years, patients continue to die every week while waiting for a transplant. About 500 people were on waiting lists for liver transplants in Canada in 2013. Eighty-six of them died while waiting.
Supporters have said they hoped Melnyk’s public experience will shine a light on the need for more organ donors. Melnyk, who has a rare blood type, went public with his need for a live liver donation after family and close friends were ruled out as suitable donors, and there was little hope of getting a liver from a deceased donor. He underwent a successful surgery Tuesday after finding a donor.
Officials with Ontario’s Trillium Gift of Life Network saw more than 3,000 online registrations the week Ottawa’s Hélène Campbell was on the Ellen DeGeneres Show in 2012. Campbell eventually received a double lung transplant.
The awareness raised by Melnyk’s plea for a live liver donor would also result in an uptick in registrations if all the people who came forward as potential donors registered to donate their organs when they die, said Ronnie Gavsie, president of Trillium.
But Gavsie said public awareness campaigns can have relatively short-term benefits and they alone aren’t enough to raise organ-donation levels to where they should be.
“These situations are not going to sustain registration at a high number, but they have a huge impact in educating very broadly.”
What is needed, she said, is a “new cultural norm” in which individuals and the health system all work toward dramatically increasing the numbers of organ donors.
Trillium says its goal is to have 51 per cent of the Ontario population registered as donors.
Ontario’s rate of organ donor registration — currently at about 26 per cent — is higher than that in much of the country, but Canada trails other nations, including the United States.
There are growing calls for changes, including a system of “presumed consent,” in which suitable organs are automatically donated unless a person has specifically opted out. Some are also calling for a change to the law to allow pilot projects in which donors’ families could be paid funeral expenses, for example. Currently, any exchange of money is illegal.
Udo Schuklenk, a bioethicist at Queen’s University, said he sees no reason to criticize Melnyk, as some have done, for using his platform to broadcast his desperate need.
“What is problematic isn’t so much this individual’s response. What is objectionable is a system that gives rise to such responses. . . . Much could be done to improve our current status quo.”
He suggested both an opt-out system for organ donations, as the country of Spain has, and, after study, a means to incentivize donating.
Maeghan Toews, a research associate with the Health Law Institute at the University of Alberta, recently gave a presentation on questioning some of the negative assumptions about financial incentives to increase organ donations. It is time, she said, to look more closely at the idea. Currently, even trying something on a pilot basis to see if it makes a difference is banned.
She said she would also like to see a presumed-consent system and more emphasis in hospitals to increase donor rates. Organ donations are vetoed by family members in as many as 10 per cent of people who have signed to consent to organ donation.
Gavsie noted that Ontario put changes in place a year ago that should increase actual donor rates, including publicly reporting hospital donation rates and trying to increase physicians’ engagement in the issue. Ontario also encourages people to discuss their wishes with their family to reduce the risk of family members vetoing donation.
Ontario Health Minister Dr. Eric Hoskins said, however, that there is no conclusive evidence the presumed-consent model leads to more donations. Some countries with the highest organ-donation rates use presumed consent and some don’t, he said. “Our focus as a province is on increasing the number of organ and tissue donors.”
Raising awareness about the need to donate and improving the ease of becoming a donor, he said, brought record numbers last year in Ontario. “It has never been easier to become a donor.”
Toews said she understands why people would take to media to try to find an organ donor, given the odds, but said she has concerns about those on waiting lists without prominent public profiles who can’t reach out in the same way.
“I think these cases raise concerns about whether we want to have an organ-allocation system where people with greater access are more likely to get one.”
Ontarians can register to donate their organs at BeADonor.ca
epaytne@ottawacitizen.com
查看原文...
