Death, Organ and Tissue Donation
A Joint Project of the Ian Anderson Continuing Education Program in End-of-Life Care Trillium Gift of Life Network (TGLN) and the Standardized Patient Program, University of Toronto
NOTE: Though originally developed for organ donor coordinators these skills are what all healthcare providers should have.
Organ donation is truly a gift of life for many members of our society. The gift of donation is often made at a time of devastating loss, and the fact that people think of saving the lives of others in the midst of their own grief is one of the most awe-inspiring expressions of humanity and compassion. Unfortunately, the need for organs far surpasses the current availability, and many people die on the waiting lists. This need has led to newer surgical techniques to divide available organs between recipients, quests to repair damaged organs through the use of genomics/protenomics, quests to develop artificial organs, and more detailed examination of current organ donation rates.
Campaigns to increase awareness of, and consent for, organ donation have occurred over the last few years. A 2004 survey commissioned by the TGLN indicates that a strong majority of Ontarians (77%) indicate they are willing to donate their own organs for transplant purposes. A majority (66%) of Ontarians indicate they would be likely to consent to donating a family member's organs even if they were unsure of the family member's donation wishes. An overwhelming majority (94%) are either very likely (85%) or somewhat likely (8%) to donate a family member's organs when they are aware of the family member's desire to be a donor. The full summary of survey results may be accessed by clicking here.
The TGLN is the provincial organization responsible for all aspects of the donation process from identification of potential donors, through surgical recovery, to the after care of donor families. It was created with the following mission statement:
"To enable every Ontario resident to make an informed decision to donate organs and tissue, and to support healthcare professionals in implementing their wishes. To maximize organ and tissue donation in Ontario in a respectful and equitable manner through education, research, services and support."
To accomplish these goals, all healthcare providers and the professional staff of the TGLN must know the ethical and legal standards surrounding consent, substitute decision-making, conflict resolution and the Trillium Gift of Life Network Act (Province of Ontario). All must be very skilled communicators in order to be able to discuss and facilitate decision-making with families or patients – in the case of tissue or living-related organ donation at an emotionally charged time in the lives of everyone involved, including families, patients and healthcare providers alike. It may be beneficial to encourage timely referals prior to discussion of donation options with the patient or patient's substitute, as this would provide the opportunity to preliminarily screen potential donors, provide additional support to healthcare provider, and prevent disappointment for family members when donation is not an option.
This module will teach the communication skills needed to communicate with the families and loved ones of patients who have sustained neurological death, and the ethical and legal frameworks relevant to organ and tissue donation.
Strategies for Companioning Families — Skills Training Modules
Videos have been used in medication education to teach communication skills and ethics. They can be used to demonstrate different approaches and as tools to facilitate self-reflection on one’s current practices and how they can be improved. They have been used in both large and small group teaching setting.
A series of five educational videos of the standardized family scenarios have been developed for the TGLN professional staff/organ donor coordinator-training program. These videos can be used to teach all healthcare providers communication skills around organ and tissue donation and to facilitate discussions, including how the emotional and informational needs of the family and patient can be best addressed.
Each video demonstrates the required communication skills and can be used as an invaluable teaching tool for teaching and helping all healthcare providers to improve their own skills. Each of the videos, while useful for teaching fundamental skills, has a different primary objective and deals with different challenges to the provider’s communication skills
Video #1: SIGNED DONOR CARD
Video #2: CONTRASTING RELIGIOUS VIEWS AND
Video #3: TISSUE DONATION
Video #4: MENTAL HEALTH AND SOCIO-ECONOMIC
Video #5 (in French): SIGNEZ VOTRE CARTE
DE DON DIORGANES ET TISSUES
Trillium Gift of Life Network
MSc, MD, FRCPC