Would an opt-out system increase organ donations? Experts say Quebec has work to do first
Nova Scotia made history in 2021 by becoming the first jurisdiction in North America to implement a presumed consent policy for organ donation. This policy automatically designates all adults as organ donors upon death, unless they had previously opted out of the program. The success of this initiative has been remarkable, with the province nearly doubling its organ donation rate and expecting to reach up to 40 donors per million people.
Following Nova Scotia’s lead, New Brunswick also adopted a presumed consent policy known as Avery’s Law, set to be implemented in 2025. However, Quebec has been advised against moving forward with presumed consent due to the need for essential improvements in the organ donation process. Despite the potential benefits of presumed consent, experts agree that addressing systemic issues is crucial for increasing organ donation rates.
Dr. Stephen Beed, the medical director of Nova Scotia’s organ and tissue donation program, emphasized that the success of the province’s program was not solely due to the consent policy itself. Instead, significant improvements were made to the organ donation system, including enhanced training for healthcare workers, better communication with hospital administrators, and a new database for tracking donor status. These changes played a vital role in increasing donation rates.
Transplant Québec CEO Martine Bouchard echoed the sentiment that presumed consent alone does not guarantee an increase in donations, as families still have the right to veto a decision under the policy. Addressing the root causes behind families’ reluctance to donate is essential for making meaningful progress in organ donation rates.
Quebec’s College of Physicians has emphasized the need for measures to improve the organ donation process before considering presumed consent. In 2023, Quebec had 23 deceased donors per million people, highlighting the need for significant improvements. The health committee at the National Assembly has recommended creating a centralized register for consent status, implementing a framework law, and designating a single organization to oversee the organ donation and transplant process in the province.
Liberal health critic André Fortin proposed implementing presumed consent in Quebec after a two-year period of public consultation and implementing the recommended changes. He emphasized the importance of ensuring that the policy is introduced in a way that addresses public concerns and supports families in making decisions.
Dr. Beed stressed the importance of strategically implementing presumed consent, including creating an opt-out registry and ensuring that families have the final say in organ donation decisions. By taking a comprehensive approach to organ donation reform and addressing key issues, Quebec can work towards increasing donation rates and saving more lives.
