Time to consider presumed consent

Re: Organ donations down sharply during pandemic: officials, Feb. 1.

In light of the shortage of organs for transplantation in Canada, it is now time to implement, or at least consider, a presumed consent, or “opt-out” donation program to increase the country's annual organ yield. Kudos to the Nova Scotia government for implementing such a law.

Under a presumed-consent program, the organs of any dead citizen would automatically be considered donation-worthy, unless the deceased had registered their objection while alive. Presumed consent programs, while not necessarily a guarantor of higher donation rates, are widespread in Europe and used by some of the world's top organ donor countries, including Belgium, Portugal and Spain.

There are approximately 3,000 Canadians on waiting list for transplants. Many will die while waiting. Many are children.

For the record, The Citizens Panel on Increasing Organ Donation, in its report submitted to the Ontario government in 2007, advised that the government cannot presume people wish to donate their organs, despite an urgent need. That panel was chaired by Dr. Ted Boadway, former director of health policy at the Ontario Medical Association, and held hearings/meetings across the province. In essence, the panel found that people in this province objected to presumed consent. The panel rejected such a regime, calling it “too passive a method to be a clear statement of an individual's intent.”

The reality is that most people do not really understand what presumed consent is. Others, I sense, construe it as government essentially telling people what to do. That said, I think it is again time for policy-makers and citizens to discuss and reference it as a part of the solution to the crisis.

A good start would be to use the term “default to donation” coined by Art Caplan, professor of bioethics at New York University Medical School, to try to get away from the misunderstanding of presuming anything about anyone's consent.