• Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne, and Donation Physician Ethics Guide Meeting Participants.
• 1 Division of Critical Care, Montreal Children's Hospital, Montreal, Quebec, Canada. 2 Department of Pediatrics, McGill University, Montreal, Quebec, Canada. 3 Canadian Blood Services, Ottawa, Ontario, Canada. 4 Department of Bioethics, Dalhousie University, Halifax, Nova Scotia, Canada. 5 Medical Professionalism, Canadian Medical Association, Ottawa, Ontario, Canada. 6 The Rehabilitation Centre, North York, Ontario, Canada. 7 University of Ottawa, Ottawa, Ontario, Canada. 8 Emergency Room and Adult Critical Care Physician, Victoria General Hospital and Royal Jubilee Hospital Victoria, British Columbia, Canada. 9 Trillium Gift of Life Network, Toronto, Ontario, Canada. 10 Critical Care, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada. 11 Deceased Donation and Transplantation, Canadian Blood Services, Ottawa, Ontario, Canada. 12 Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada. 13 John Dossetor Health Ethics Centre, University of Alberta, Edmonton, Alberta, Canada.
• Transplantation. 2017 May 1; 101 (5S Suppl 1): S41-S47.

AbstractDonation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services. In anticipation of actual, potential or perceived ethical challenges with the role, Canadian Blood Services in partnership with the Canadian Medical Association organized the development of an evidence-informed consensus process of donation experts and bioethicists to produce an ethics guide. This guide includes overarching principles and benefits of the DP role, and recommendations in regard to communication with families, role disclosure, consent discussions, interprofessional conflicts, conscientious objection, death determination, donation specific clinical practices in neurological determination of death and donation after circulatory death, end-of-life care, performance metrics, resources and remuneration. Although this report is intended to inform donation physician practices, it is recognized that the recommendations may have applicability to other professionals (eg, physicians in intensive care, emergency medicine, neurology, neurosurgery, pulmonology) who may also participate in the end-of-life care of potential donors in various clinical settings. It is hoped that this guidance will assist practitioners and their sponsoring organizations in preserving their duty of care, protecting the interests of dying patients, and fulfilling best practices for organ and tissue donation.

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