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Canadian Society of Transplantation White Paper: Ethical and Legal Considerations for Alcohol and Cannabis Use in Solid Organ Listing and Allocation.
- Source :
-
Transplantation [Transplantation] 2021 Sep 01; Vol. 105 (9), pp. 1957-1964. - Publication Year :
- 2021
-
Abstract
- Alcohol and cannabis use as a contraindication to organ transplantation is a controversial issue. Until recently, patients in Canada with alcohol-associated liver disease were required to demonstrate abstinence for 6 mo to receive a liver transplant. There is no equivalent rule that is applied consistently for cannabis use. There is some evidence that alcohol and cannabis use disorder pretransplant could be associated with worse outcomes posttransplantation. However, early liver transplantation for patients with alcohol-associated liver disease in France and in the United States has led to challenges of the 6-mo abstinence rule in Canada in the media. It has also resulted in several legal challenges arguing that the rule violates human rights laws regarding discrimination in the provision of medical services and that the rule is also unconstitutional (this challenge is still before the court). Recent legalization of cannabis use for adults in Canada has led to questions about the appropriateness of limiting transplant access based on cannabis use. The ethics committee of the Canadian Society of Transplantation was asked to provide an ethical analysis of cannabis and alcohol abstinence policies. Our conclusions were as follows: neither cannabis use nor the 6-mo abstinence rule for alcohol use should be an absolute contraindication to transplantation, and transplant could be offered to selected patients, further research should be conducted to ensure evidence-based policies; and the transplant community has a duty not to perpetuate stigma associated with alcohol and cannabis use disorders.<br />Competing Interests: The authors declare no funding or conflicts of interest.<br /> (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Subjects :
- Alcohol Abstinence
Alcohol Drinking legislation & jurisprudence
Canada
Clinical Decision-Making
Consensus
Contraindications, Procedure
Evidence-Based Medicine standards
Government Regulation
Humans
Marijuana Smoking legislation & jurisprudence
Organ Transplantation adverse effects
Organ Transplantation ethics
Organ Transplantation legislation & jurisprudence
Patient Selection
Policy Making
Risk Assessment
Risk Factors
Tissue and Organ Procurement ethics
Tissue and Organ Procurement legislation & jurisprudence
Alcohol Drinking adverse effects
Health Policy legislation & jurisprudence
Marijuana Smoking adverse effects
Organ Transplantation standards
Tissue and Organ Procurement standards
Subjects
Details
- Language :
- English
- ISSN :
- 1534-6080
- Volume :
- 105
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 33587429
- Full Text :
- https://doi.org/10.1097/TP.0000000000003618