Survey of Canadian Intensive Care Physicians' Attitudes Towards a Presumed Consent Model for Deceased Organ Donation
CCCF ePoster library. Weiss M. Nov 7, 2018; 233332; 30 Disclosure(s): Yes
Dr. Matthew J. Weiss
Dr. Matthew J. Weiss
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A presumed consent model of organ donation assumes all people of a defined geographic area consent for deceased organ donation unless they have expressed otherwise. Various forms of presumed consent exist (1) that are often implemented to increase donation rates, but have yielded mixed results (2-4). Literature reviews on the topic suggest that a presumed consent model is unlikely to increase donation rates unless done in a transparent manner with broad support of the public and healthcare professionals (2,5). The current opinion of Canadian intensive care physicians towards presumed consent for organ donation is unknown. The last reported national survey of healthcare workers (including non-physicians) on the topic was published in 2006 (6), with 59% somewhat or strongly supportive of a presumed consent model.



Survey practicing adult and pediatric intensive care physicians on their attitudes towards a presumed consent model for deceased organ donation. Presumed consent questions were embedded in a larger survey on deceased donation practices in Canada.



We conducted a cross-sectional survey of Canadian intensive care physicians. We followed a standardized approach for design and conduct of self-administered surveys (7), including item generation and reduction using modified Delphi methods, survey validation for clarity, redundancy and comprehensiveness, and test-retest reliability assessments. Our sampling frame included all intensivists practicing in an institution that may care for potential organ donors. Intensivists were identified by merging lists obtained in collaboration with Canadian Blood Services, the Canadian Critical Care Society and manual searches from publicly available sources (e.g. hospital websites). The survey was administered using an online platform (LimesurveyTM) from February 26 to March 26, 2018 with two e-mail reminders. Survey responses are reported using descriptive statistics.



550 potential respondents were identified, of which 21 did not meet inclusion criteria and 1 participant declined consent. The response rate was 49.7% (263/529) and the completion rate 89.4% (235/263). Overall, 95.7% of respondents had a mostly positive or positive general opinion regarding organ donation in general. When asked if they would be in favor of a change towards a presumed consent model, 62.2% agreed or strongly agreed, 18.7% were neutral and 20% disagreed or strongly disagreed. 77% stated they believe a presumed consent model would increase organ donation rates, 25% expressed that such a model would increase the likelihood that they would approach a family to discuss organ donation.



In our survey, a majority expressed support for a presumed consent model. Though not asked in exactly the same manner or of the same population, the rate of support for presumed consent seems largely stable since a 2006 survey (6). A larger majority believed that a presumed consent model would increase organ donation rates, even though most respondents did not indicate they would be more likely to approach families and surrogates of patients who are potential donors. Further research is required to better understand attitudes and knowledge of if and how a presumed consent model should be implemented in Canada. 


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