Nova Scotia’s Liberal premier, Stephen McNeil, made national headlines last week when he introduced legislation that will potentially make everyone in that province an organ donor unless they register to opt out.
That was considered a major move since in the rest of the country organ donation occurs only when people specifically opt in and declare themselves to be donors.
This is the first time what’s known as “presumed consent” legislation will become law anywhere in Canada or the United States. But it’s far from new elsewhere in the world.
The same principle for organ and tissue donation has been adopted by countries as diverse as Spain, Belgium, France, Austria, Greece, Argentina and Chile. And perhaps most relevantly for Canada, Britain passed presumed consent legislation for organ donation in February.
This is, in other words, not a radical concept. It’s time for other provinces to follow Nova Scotia’s lead and pass similar legislation to help those whose lives can be saved by receiving an organ from a donor.
The fact is about 4,500 people are on waiting lists for organ donations in Canada in any given year and the wait for a transplant can be up to six years. Sadly, about 250 people die each year waiting for such organs as hearts and lungs.
There’s no need for that. Passing presumed consent legislation simply takes advantage of the overwhelming support for organ donation that is limited largely by the fact that people don’t take the time to register for it.
Indeed, studies show that presumed consent legislation makes an enormous difference in the willingness to be an organ donor between similar cultures.
For example, in Germany, where people must opt in, the consent rate is only 12 per cent. But in Austria, which has opt-out legislation in effect, the consent rate is an astonishing 99.98 per cent.
Similarly, about 90 per cent of Canadians say they support organ donation but less than 20 per cent have actually made plans to donate, though they will do so when given a “nudge.”
That’s what more than 100,000 people did, for example, after the death of Humboldt Broncos defenceman Logan Boulet just over a year ago.
The 21-year-old had registered to be an organ donor weeks before the horrific bus crash in which he and many of his teammates died. His donations saved six lives and inspired people across the country to become donors.
In the end, it appears that one of the biggest things holding governments back from adopting life-saving presumed consent legislation isn’t a lack of public support but what might be described as the “creep factor.” That’s the unfounded fear among some that doctors might harvest their organs against their will or even before they’re dead.
Fear not. Legislators around the world are careful to include checks and balances — including strict definitions of death — to reassure donors.
For example, Nova Scotia’s opt-out policy won’t apply to those who have moved to the province in the previous year, those under 19 (unless a parent, guardian or alternate decision-maker opts them in), and those who lack the capacity to understand the concept.
And the law won’t be proclaimed until 12 to 18 months after it is passed to allow time for a public education campaign to alert those who want to opt out.
Further, reassuringly, families will be consulted about their loved ones’ wishes regarding organ or tissue donation before it takes place. That means if someone simply neglected to opt out their family will get the last say.
That, too, is why it is so important for individuals to communicate their wishes to their families, so no one has to make that decision in a time of grief.
Nova Scotia has opened up a discussion on organ donation that should be taking place not just in every province, but in every home. The sooner, the better.
https://www.thestar.com/opinion/editorials/2019/04/09/nova-scotia-is-showing-the-way-on-organ-donation.html
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