brain death laws needed
WHILE 250 persons have died from kidney disease in Barbados, policy makers are being told to move towards legislation to support brain death so that the Queen Elizabeth Hospital (QEH) can move forward with its organ transplant programme.
This call was made by QEH’s Chief Executive Officer (CEO), Dr Dexter James, who said that there are about ten brain deaths at the Hospital annually.
“If we had legislation in place, we imagine with the proper ethical framework in place, and a good transplant programme in place, we would have had two hearts, two kidneys…Ten by two is 20. Potentially, we could have had at least 20 patients on the kidney side having transplantation.
“So this legislation is very important to support our transplantation programme, as well as to provide one of the three clinical [programmes] for aggressive renal diseases. There is haemodialysis, peritoneal dialysis, and the third really deals with our transplantation programme,” he said.
Dr James said the move towards this legislation needs to be made quickly as the reality stands that the Hospital’s Renal Unit is currently operating at maximum capacity and is unable to treat any new patients, unless there is a death.
“We need to expand dialysis treatment capacity in the short term. It is pretty much at capacity now. We have moved from a contract of 24 patients being outsourced to 36, now we are up to 43. So we really need to look at a short-term solution to expand capacity.
“This could be done by issuing a tender to see if there are any private sector providers… Certainly, at the Queen Elizabeth Hospital, we are full to capacity.
“We can’t take one more patient, except someone dies, and then we could fit them in. But in terms of additional numbers, in terms of haemodialysis, we cannot accept any more patients,” he said.
Dr James spoke about QEH’s reality as it relates to treating kidney patients, as he delivered remarks at the Hospital’s World Kidney Day Seminar, themed “Kidneys & Women’s Heath: Include, Value, Empower”, held in QEH’s Auditorium. The CEO’s speech was titled: “Setting the Scene – The QEH Reality”.
Dr James said the Hospital currently spends 19 million dollars on treating patients who have kidney diseases, a figure which he revealed could possibly move to 25 million if the problem is not brought under control sooner rather than later.
In addition to expanding dialysis treatment capacity through the outsourcing option, the Chief Executive Officer also gave a number of other National Health Public Policy considerations that can be seriously looked at.
He suggested that an aggressive screening programme is needed to identify at-risk populations, expanding capacity to treat and manage non communicable diseases (NCDs) by including private sector physicians through credentialing by the Ministry of Health (MoH).
Dr James also said that consideration must be taken as it relates to relocating haemodialysis as an outpatient service and vertical programme under the MoH.
He added that there is need for the selection criteria for treatments to be reviewed, and the setting up of a multi-disciplinary team, including social workers, psychologists, nutritionists and podiatrists, to support treatment sites.
(AH)