Less than a week has passed since the Nova Scotia government introduced a bill that would make it the first jurisdiction in North America to adopt presumed consent for organ donations. But those opposed to the move feel it could give governments and hospitals too much control.
Premier Stephen McNeil, who sponsored the bill, said the goal of presumed consent is to ensure there are more potential organ donors in order to save lives. The Human Organ and Tissue Donation Act would presume people consent to donating organs when they die unless they specifically opt out.
“When this bill passes, we will all be considered organ donors,” McNeil said Tuesday.
But the Canadian Civil Liberties Association is troubled that children and others who lack the capacity to make decisions could still be donors if an alternate decision-maker opts them in.
“There’s a strong sense that individuals have and should have autonomy over what happens to their body, and that the state or the province shouldn’t be involved in making decisions that infringe on that integrity,” said Cara Zwibel, director of the Canadian Civil Liberties Association’s fundamental freedoms program.
Under the legislation, those under 19 and people without decision-making capacity would be exempt. They would only become donors if a parent, guardian or alternate decision-maker opts them in.
The legislation also would take over a year to go into effect.
The majority of countries with high donor rates use presumed consent. Canada’s rate is much lower. A report from the Parliamentary Research Service notes some countries with lower rates than Canada, including Poland and Sweden, also have presumed consent, suggesting it’s not always an improvement.
But Nova Scotia is leading on the matter in part because other provinces have said no.
“At this point in time, there doesn’t seem to be any impetus for Ontario itself to move to presumed consent, although we continually debate it,” said Ronnie Gavsie, president of Trillium Gift of Life Network, an Ontario-based organ and tissue donation agency.
There are powerful examples of donors making a difference. Logan Boulet, who lost his life in the Humboldt Broncos bus crash, helped save six lives after his wish to donate organs was honoured.
But in Nova Scotia, reaction to the switch to presumed consent remains mixed.
“Well, I’m not going to use them when I die, so I’m thinking if somebody can use my organs, go right ahead,” said one Halifax resident.
“My God, what’s the world coming to?” said another. “They’re telling us what to do with our bodies? No, I think it should still be the old way.”
Building a new network for organ donation is an ambitious plan for a health-care system that’s barely keeping up with the status quo. But the province insists it can be done.
“This is not by itself going to solve or going to increase the number of organ donations within our province,” McNeil said. “We know that it will require some support.”
According to the province, 21 Nova Scotians became organ donors in 2018, while 110 people donated tissues such as corneas and heart valves.
Currently, 110 people are waiting for organ transplants.
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To sign up to become an organ donor, visit the CTA website or Organ Tissue Donation and select your province to complete the requisite forms. You can also sign up in person.
With files from The Canadian Press.