Organ donation following medical assistance in dying series: a scoping review – Part 2 – existing processes and procedures

Abstract

Objective: The objective of this review is to collate and summarize the current literature on what is known about organ donation following. For this part II of a 2-part series scoping review, the focus is on the existing procedures and processes for organ donation following MAiD. Introduction: Organ donation following MAiD is a novel and contentious issue worldwide. To give direction for future research and initiatives, a comprehensive understanding of the available evidence of existing procedures and processes for organ donation following MAiD is needed. Inclusion criteria: For this review, our population of interest included all individuals who underwent organ donation following MAiD; our concept was defined as procedures and processes involved in organ donation after MAiD; and the context was reports of organ donation following MAiD at home or in any health care setting worldwide. We considered quantitative and qualitative studies, text and opinion papers, gray literature, and unpublished material provided by stakeholders. Methods: This scoping review was conducted in line with JBI methodology. Published studies were retrieved from MEDLINE (Ovid), Embase, CINAHL (EBSCOhost), PsycINFO (Ovid), Web of Science – Science Citation Index and Social Science Citation Index, and Academic Search Complete (EBSCOhost). Gray and unpublished literature included reports from websites and organ donation organizations in Canada, Belgium, and The Netherlands. Two independent reviewers screened all reports (both title and abstract, and full text) against the predetermined inclusion criteria, extracted data, and completed a content analysis. Any disagreements between the 2 reviewers were resolved through discussion or with another author. Results: We included 121 documents across the two-part series, and we are reporting on 103 in this part II. The majority of the 103 documents were discussion papers, published in English and in Canada from 2019 to 2021. In the content analysis, we identified 5 major categories regarding existing procedures and processes of organ donation following MAiD: i) clinical pathways for organ donation following MAiD; ii) organ donation following MAiD and the donor; iii) clinical practice tools for organ donation following MAiD; iv) education and support for health care providers involved in organ donation following MAiD; and v) health care providers’ roles and perceptions during organ donation following MAiD. Conclusions: Findings from this review can be used to provide support and guidance for improvements in procedures and processes, as well as a rich resource for countries currently planning to establish programs for organ donation after MAiD.