GESTIÓN EN SALUD PÚBLICA: BioEdge: Spain, organ donation champion of the world

domingo, 15 de enero de 2017

BioEdge: Spain, organ donation champion of the world

BioEdge: Spain, organ donation champion of the world
Bioedge

Spain, organ donation champion of the world

by Michael Cook | 14 Jan 2017 |

Spain is leading the world in deceased organ donation. An article in the American Journal of Transplantation explains how this happened.
In 1989, the Spanish Ministry of Health created the Organización Nacional de Trasplantes (ONT), a technical agency in charge of the coordination and oversight of donation and transplantation activities in Spain. It created a model of coordination in deceased donation that made the country evolve from 15 donors per million population to more than 30 per million in less than a decade.
The Spanish model relies on designated professionals (mostly intensive care doctors) who make donations happen when a potential donor dies. These professionals are supported in their work by ONT and regional coordination offices.
The Spanish model also makes it a priority to identify donation opportunities not only in intensive care units, but also in emergency departments and hospital wards. In addition, it considers organ donation from persons over the age of 65 years. (While only 7% of organ donors are over the age of 65 years in the United States, 10% of organ donors in Spain are over the age of 80.)
Furthermore, the model has considered donation after circulatory death, in which circulation, heartbeat, and breathing have stopped (as opposed to brain death, in which all the functions of the brain have stopped), even in the setting when death follows a sudden cardiac arrest in the street.
"The most important success is that the system has made organ donation be routinely considered when a patient dies, regardless of the circumstances of death," said ONT's Beatriz Domínguez-Gil. "Professionals attending to these patients in our country consider that, in caring for patients at the end of their lives, it is their duty to systematically explore their wishes with regards to donating organs upon their death."
Lead author Rafael Matesanz, who is the director of ONT, highlighted that "good organization in the process of deceased donation and continuous adaptations of the system to changes are always the basis of successful results in organ donation".

Transplant surgeons in Belgium and the Netherlands are already harvesting organs from patients who have requested euthanasia. Could this happen in Canada, the new kid on the euthanasia block? Perhaps. In a recent article in the Journal of Medical Ethics, two bioethicists from Quebec argue that organ donor euthanasia is a homage to autonomy and needs to be legalised. Apparently the Quebec government and the society of transplant surgeons in Quebec are also on board.

Of all the bad ideas associated with euthanasia, this must be one of the worst. The potential for exploiting vulnerable people is immense. Imagine that you are a quadriplegic. Your organs are healthy; you are lonely, frustrated, discouraged. You see a TV program in which a doctor praises the unforgettable generosity of So-and-so whose life was not worth living but found a way to give life to others, etc, etc. Wouldn't you think of ringing up the doctor and asking him how to go about it?

Will Canada be able to stop this from happening?