This film is the extraordinary story of Dr. Shelly Sarwal, a physician from Halifax, Nova Scotia. Diagnosed with Multiple System Atrophy (MSA), an incurable disease, Shelly chose to undergo the recently legalized Medical Assistance in Dying (MAID) procedure and become an organ donor. As the first person in Nova Scotia to undergo this complicated medical journey, she dedicated the short time she had left on this earth to educate health professionals and the public about being in control of your death and creating a meaningful legacy through organ donation.
About Dr. Shelly Sarwal
Born in Halifax, Shelly was a graduate of Dalhousie Medical School, McMaster University residencies in internal medicine and medical microbiology and a fellowship in infectious diseases, the London School of Hygiene and Tropical Medicine, and the Canadian Field Epidemiology Program. She had an amazing career in public health and the only thing she loved more than stamping out disease and pestilence was teaching others how to do the same. As her final act of teaching, after her organs were donated, her brain was left to the Maritime Brain Tissue Bank.
Her Last Project is directed by Emmy-nominated Rosvita Dransfeld and produced by Canadian Blood Services, in partnership with Legacy of Life at the Nova Scotia Health Authority.
Produced by Canadian Blood Services and Nova Scotia Health Authority – Legacy of Life
Executive Producers: Amber Appleby and Rosvita Dransfeld
Director of Cinematography: Marcia Conolly | Editor: Brenda Terning | Music: APM
Sound Design: Philip Dransfeld | Production Designer: Adrian De La Pena
Project Lead: Ken Lotherington
About Rosvita Dransfeld, Director
German-born producer Rosvita Dransfeld is an Emmy-nominated, internationally renowned documentary filmmaker who crafts powerful explorations of the human condition. Her films include Who Cares, Antisocial Limited and Broke, winner of a Gemini Award and the prestigious Donald Brittain Award for Best Social/Political Documentary.
Most recently Dransfeld has completed Memento Mori and Vital Bonds – two high profile documentaries for CBC’s The Nature of Things and CBC Documentary Channel, NOVA (PBS), SBS (Australia) and DR (Denmark). Transplanting Hope, an adaptation of Vital Bonds for NOVA/WGBH has just been nominated for an Emmy Award in the best science program category. Currently Dransfeld is in production with Queens of Dogsville, a timely parody set in the world of dog sports. (Photo credit: ID Productions)
About Organ and Tissue Donation in the Conscious Competent Patient
Patients with illnesses that are incurable and terminal but not associated with devastating brain injury may also be conscious and competent. These patients are capable of actively participating in decisions about their end-of-life care, including decisions for withdrawal of life sustaining measures or medical assistance in dying. They also have the autonomy to make their own decisions about organ donation and are able to provide first-person consent. While substitute decision makers and family members are welcome and encouraged to be a part of the donation conversations, consent for organ and tissue donation following MAID or WLSM is obtained directly from the conscious and competent patient.
Nearly 20 per cent of the approximately 3,000 annual MAID deaths in Canada may be eligible for deceased organ and tissue donation. Canadians are requesting organ and tissue donation after MAID, demonstrating that this is a conversation dying patients are having and a choice they are making.
In response to patient requests for organ and tissue donation after MAID and the medical community looking for guidance in these cases, Canadian Blood Services led the development of national guidance. Dr. Shelly Sarwal was one of the patient partners who participated in this work sharing her unique perspective. Through Her Last Project, Dr. Sarwal is a pioneer in bringing this conversation to the forefront.
Read more: Deceased organ and tissue donation after medical assistance in dying and other conscious and competent donors
According to current legislation, to be eligible for receiving medical assistance in dying, you must be:
- eligible for health services funded by a government in Canada;
- at least 18 years of age and capable of making decisions with respect to your health;
- have a grievous and irremediable medical condition;
- have made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure; and
- give informed consent to receive medical assistance in dying.
The expert community considers organ and tissue donation a part of quality end of life care. It is their belief that a patient who chooses MAID should be given the opportunity to consider organ and tissue donation at the time of their death. Conscious and competent, these patients have the autonomy to make their own decisions and are able to provide first-person consent.
About Nova Scotia Health Authority and Legacy of Life
Nova Scotia Health Authority provides health services to Nova Scotians and some specialized services to Maritimers and Atlantic Canadians. We operate hospitals, health centres and community-based programs across the province. Our team of health professionals includes employees, doctors, researchers, learners and volunteers that provide the health care or services you may need.
Partnerships are important to us. We work in partnership with community groups, schools, governments, foundations and auxiliaries and community health boards. Whether we are hosting wellness programs in the community, conducting innovative research in labs, or helping a patient recover in hospital; we are creating a healthier Nova Scotia.
Legacy of Life is the provincial deceased donation program for Nova Scotia. Established in 2006, the program strives to ensure every Nova Scotian knows about deceased donation and is routinely provided with the opportunity to become a donor as part of optimal end-of-life care. This is achieved through education of the public and healthcare community, adherence to leading care practices and donor family support.
About Canadian Blood Services
Canadian Blood Services operates with a national scope and infrastructure that makes it unique within the Canadian health care system.
In the domain of organs and tissues Canadian Blood Services manages programs that facilitate inter-provincial organ sharing and works in collaboration with provincial programs and partners to improve the organ donation and transplantation system.
Initiatives led by Canadian Blood Services include the development of leading practices, professional education, public and professional awareness campaigns, and system performance data collection, analysis and reporting
- Every year, thousands of Canadians are added to organ waitlists. There are more than 4,400 people waiting for organ transplants in Canada and an estimated 250 die while waiting for a transplant.
- A single organ donor can save up to eight lives. Eye and tissue donors can improve the lives of up to 75 patients.
Learn more about organ and tissue donation in Canada at blood.ca/organs-tissues