MD Questions Ethics Of Organ Donation Push

Michael Lau

Calgary Herald

Bertha Pearson has a new pacemaker, takes regular medication and sleeps up to 16 hours a day, but the Calgary heart patient still can't walk around the block.

"I have absolutely no energy to do anything," said Pearson, a 61-year-old wife and mother of two who's been waiting since May for a heart transplant.

A heart attack two years ago forced Pearson to quit her job as a data entry clerk after 26 years. She's been at Foothills Hospital four of the past six months.

She supports the conclusions of a committee which calls for more money and provincial policies to pressure physicians into asking the difficult questions of potential donors or families of the deceased.

Dr. Brock Dundas, president of the Calgary Regional Medical Staff Association, said physicians would likely balk at a mandatory system.

If the new system is approved, the committee predicts another 90 heart, liver, lung and kidney transplants would be performed each year in Alberta, a province where 22 people died last year due to the chronic shortage of vital organ donations.

Almost 100 Albertans were waiting for heart, lung or liver transplants at the end of last year -- a list patients such as Pearson hope will be dramatically shortened by the measures.

Provincial Health Minister Gary Mar said he wants Albertans to be as inclined to donate organs as they are to give blood. "We need to create the same kind of support for organ donation as we have for blood donation," said Mar.

"When it comes to blood donation, people are motivated to act. But organ donation, people are not as inclined to action. There's a wide understanding of its importance, but we have to get people to act on those good thoughts that they have."

Last week, Ontario said its hospitals will soon be required by law to discuss the possibility of organ and tissue donations with grieving families that have just lost a loved one.

But Mar said he doesn't think legislation similar to Ontario is needed.

"I wouldn't be planning on taking the same strategy as in the province of Ontario. To compare it to blood donation, we don't have legislation that compels people to do that, and yet people do it because they know it's the right thing to do."

A mandatory system is not supported by all health-care workers.

Dundas said the issue raises ethical questions. "Obviously, we all have a responsibility at certain points in time of saying one of your options is to make an organ donation and prolong somebody else's life," he said.

"What I have a problem with is if there's any effort to force physicians to do something like that. I think most of them understand their responsibility. It's an important issue and there are some serious ethical considerations. One of the things that has to be respected is that physicians find it a delicate issue."

Dr. Debra Isaac, director of the Southern Alberta cardiac transplant clinic, said she favours an educational approach over pressure tactics.

"Every situation is different and I would hate to see a mandate where you will be fined if you don't do X --that's too heavy handed," said Isaac, a transplant cardiologist at Foothills Hospital.

The number of organ donors in Southern Alberta more than doubled last year to 30 from 14 in 1997, but there's a long way to go, she said.

Yvette Elmquist, Southern Alberta co-ordinator for Human Organ Procurement and Exchange (HOPE), said the recommendations are meant to ensure a consistent and thorough approach to organ and tissue donation.

"Our hospitals are doing a great job right now but we want to ensure that we continue to ask every individual family member at the time of death about organ and tissue donation," said Elmquist, who sits on the advisory committee on organ and tissue donation.

"We would like to be a benchmark for the rest of Canada."

Establishing the new provincewide organ donation network would cost $9 million in the first three years of operation, but would save considerably more than it costs by eliminating dialysis treatment for kidney recipients, the advisory committee report notes.

Copyright © 2000 Calgary Herald New Media.

This article posted July 28, 2000.