117.3: Organ donation following medical assistance in dying: a scoping review
Bibliographic record
Abstract
Introduction: Organ donation following Medical Assistance in Dying (MAiD) is a relatively new procedure when compared to the well-established practices of deceased organ donation after neurological determination of death. Currently, the only countries allowing for donation after MAiD are Canada, Netherlands, Belgium and most recently Spain. To inform changes in the practice guidelines and ensure ethically acceptable procedures, we examined the international literature on the existing processes, outcomes and ethical debates regarding organ donation following MAiD. Methods: Scoping review using the JBI framework. Published literature was searched on Ovid MEDLINE, Ovid Embase, CINAHL via EBSCOhost, Ovid PsycINFO, Web of Science – Science Citation Index and Social Science Citation Index via Clarivate, and Academic Search Complete via EBSCOhost. Gray and unpublished literature included materials from organ donation organizations. Reports were considered if they discussed organ donation following MAiD at home or in any healthcare setting in any country. Reports were screened, and data extracted and analyzed by two independent reviewers. Results: The search process yield 1879 reports and 121 were included in this review. Most reports were in English (n=95), from Canada (n=51), and published between 2019-2021 (n=57). Results from this review (Figure 1) identified the following major theme areas: the main processes and procedures involved in organ donation after MAiD in the hospital and at home; the main clinical pathways involved in different settings; ethical dilemmas involved in this combined procedure; healthcare professionals’ roles and perceptions; impacts on the organ donation system; transplant outcomes; public perceptions; safety processes and tools in place; educational strategies for healthcare professionals involved; and suggestions for future research to address knowledge gaps. Conclusion: Findings from this scoping review can be used by researchers and clinicians as a rich source of information for countries with organ donation following MAiD and provide important directions for improvements in the current organ donation and transplantation system using MAiD donors.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.076 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.032 | 0.038 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.009 | 0.007 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.005 | 0.003 |
| Insufficient payload (model declined to judge) | 0.015 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".