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Every French citizen presumed to be organ donor under new law

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Every French citizen presumed to be organ donor under new law
WATCH: Could presumed consent help increase France's organ donation rates? – Jan 5, 2017

France has passed a law making every citizen an organ donor, unless they opt out by registering with a national refusal registry.

The presumed consent law, which came into effect on Jan. 1, was passed in hopes of increasing organ and tissue donation.

According to France’s national agency for biomedicine (Agence de la biomédecine), individuals who do not wish to be an organ or tissue donor can either officially register their refusal or express their wishes to family who will be consulted before a donation is made.

U.K.’s The Guardian reported that in a matter of one day, 150,000 citizens signed up for the refusal registry.

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In Canada, organ donation registration is managed provincially or territorially. Registration in Saskatchewan is the lowest in the country with less than one per cent of the province’s eligible residents having registered.

In November, Saskatchewan Premier Brad Wall sought to implement the presumed consent model. The province’s Standing Committee on Human Services opposed the plan, but provincial Health Minister Jim Reiter told Global News last month that they were still hoping to pass presumed consent in the province.

Ronnie Gavsie, president and CEO of Ontario’s organ donation agency, Trillium Gift of Life, said presumed consent seems like a silver bullet but research shows it’s not.

Citing Spain and Singapore as examples of where presumed consent alone didn’t have a dramatic impact on donation rates, Gavsie said implementing better policy and infrastructure to encourage more organ donation has seen increased rates.

“Numbers [in Ontario] have gone up since we’ve put in place hospital donation physicians, stringent policies including mandatory approach of every family giving them the opportunity to decide, and public reporting,” said Gavsie.
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“Based on what we’ve learned from other jurisdictions, I do not expect presumed consent will make a difference.”

In Ontario, 30 per cent of eligible donors are registered, up from around 24 per cent in the last five years. Gavsie said new data being released in the next few months indicates a positive trajectory year over year.

Dr. Amit Garg, a kidney specialist and researcher with the London Health Sciences Centre and Institute for Clinical Evaluative Sciences, told Global News that Canada’s current model of registering consent always defers to the next of kin to make the final decision – as does presumed consent – so it wouldn’t make a positive difference.

“Most experts would say [presumed consent] is not the solution because we’ve shown that both systems operate in similar ways when someone dies,” he said.

James Breckenridge, president and CEO of the Canadian Transplant Association echoed this, saying that the presumed consent model could add doubt into the minds of family members if the deceased didn’t voice any opinion.

Garg added that the language of “presumed consent” is touchy, eliciting an emotional or negative reaction. He explained that presumed consent generated such a strong backlash in Brazil that the law was changed back to an elective model in 1998.

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Gavsie, Garg and Breckenridge agreed that Canadians should discuss their decision with family and friends so as not to leave them hanging should the situation arise. And if they decide to donate, they should register their consent.

“It’s really a situation where it’s personal to a lot of people and we have to respect their wishes and try and get them to instead understand the importance of what organ donation is,” said Breckenridge. “The alternative is that your organs are destroyed and not saving any lives.”

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