• Matthew J Weiss, Shane W English, Frederick D'Aragon, François Lauzier, Alexis F Turgeon, Sonny Dhanani, Lauralyn McIntyre, Livia P Carvalho, Michael Yu, Sam D Shemie, Gregory Knoll, Dean A Fergusson, Samantha J Anthony, Adnan Haj-Moustafa, David Hartell, Jim Mohr, Michaël Chassé, and Canadian Critical Care Trials Group.
• CHU de Québec - Université Laval Research Center, Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Université Laval, Québec, QC, Canada. matthew-john.weiss@chudequebec.ca.
• Can J Anaesth. 2020 Oct 1; 67 (10): 134913581349-1358.

PurposeWe surveyed Canadian critical care physicians who may care for patients who are potential organ donors to understand their attitudes and knowledge of legislation governing the deceased organ donation system.MethodsWe used a web-based, self-administered survey that included questions related to opt-out consent and mandatory referral legislation. Potential participants were identified through membership lists of professional societies and manual searches. We designed our survey using standardized methods and administered it in February and March 2018.ResultsFifty percent (263/529) of potential participants completed the questionnaire. A majority (61%; 144/235) supported a change towards an opt-out consent model, and 77% (181/235) stated they believe it would increase donation rates. Asked if opt-out consent would change their practices, 71% (166/235) stated an opt-out model would not change how or if they approach families to discuss donation. Fifty-six percent (139/249) supported mandatory referral laws, while only 42% (93/219) of those working in provinces with mandatory referral correctly stated that such laws exist in their province. Respondents gave variable responses on who should be accountable when patients are not referred, and 16% (40/249) believed no one should be held accountable.ConclusionsWhile a majority of critical care physicians supported opt-out consent and mandatory referral, many were neutral or against it. Many were unaware of existing laws and had variable opinions on how to ensure accountability. Efforts to increase understanding of how legislative models influence practice are required for any law to achieve its desired effect.

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