Health-care officials seek to dispel misconceptions with Nova Scotia's organ donation bill

Representatives with the province's organ donation program say a bill that would make Nova Scotians default organ donors isn't taking away choice and could increase rates by as much as 50 per cent.

Bill 133, The Human Organ and Tissue Donation Act, was introduced at Province House last week. It uses presumed consent for everyone in the province, requiring instead that people opt out if they don't want to be registered as a potential donor.

The bill would not apply to people who are younger than 19, are incapable of giving consent or who have just moved to Nova Scotia, and health teams would still need to speak with next of kin before donations could be done.

Janet Gallant, program manager for the province's Legacy of Life and critical care organ donation program, told the legislature's law amendments committee Tuesday they've been overwhelmed by the response to the bill, but they also wanted to dispel some myths and misconceptions.

What the bill is not

The bill is not about donation for anatomical research. It's also not about donation of reproductive materials for the purpose of reproductive medicine. And organs and tissues will not be warehoused.

Organs are only taken from a potential donor if there is a medical suitability, said Cynthia Isenor, director of critical care for the province's central health zone. People have to meet clinical criteria to show the organs are healthy and there needs to be someone who can receive the donation within a matter of hours.

"Those organs are not recovered and stored for a later date," said Isenor. "They just would not be safe for transplantation."

Isenor said the bill does not take away the right to choose, rather it reverses the premise of the choice. The opt-in system has not helped donation rates, with Nova Scotia and Canada having some of the lowest rates in the world despite 90 per cent of Canadians indicating support for organ and tissue donation.

In Nova Scotia, the donor registration rate is about 53 per cent. It's much lower in provinces such as Ontario and British Columbia, said Dr. Stephen Beed, medical director of Nova Scotia's organ donation program.

"There's a gap between what people clearly say when they're asked, and what they've actually done in terms of registering."

While the opt-out portion of the bill is what's getting the attention, Beed said change will only happen if the necessary supports for the system are in place. He doesn't think it's unreasonable to expect donations to go up by 30 per cent in the next five years with everything in place.

"And if we were 50 per cent ahead, I wouldn't be shocked."

Premier Stephen McNeil has said government has budgeted several million dollars to support the new system. But officials noted Tuesday that as more people are able to get transplants, the cost of supporting them while they wait will be removed. The most obvious example, said Beed, is people waiting for kidneys who require dialysis.

"That's an expensive treatment that's difficult on patients."

A huge deal

In 2018, 21 Nova Scotias became organ donors and 110 donated tissue. There are 110 people waiting for a transplant. Beed said the program here has about four organs per donor. To get 10 more donors would mean "40 more people who have life-saving treatments," he told reporters.

"That's a huge deal to those 40 people and their community."

The bill is on track to pass on Friday, but it will be 12-18 months before it is proclaimed and becomes law. During that time, officials will work to finalize and refine the new system, ensure necessary supports are in place and engage in an extensive public education campaign.

Isenor said the opt-out system would be an "explicit and obvious process" that's also culturally sensitive.