Under the updated provincial Human Organ and Tissue Donation Act, it is assumed as of Jan. 18 that people who have not registered their wishes about organ donation have consented to becoming organ donors.
Nova Scotia is the first jurisdiction in North America to shift to an “opt out” organ donation system, a move heralded as a major achievement at this past weekend’s COVID-muted Liberal leadership convention.
Dr. Stephen Beed, medical director of Nova Scotia’s organ and tissue donation program, told the Chronicle Herald newspaper that the move comes with changes in the care system that include enhanced education for health-care providers and more support for families through the donation process.
Addressing the province’s legislative health committee on Dec. 8, Beed offered some context about how organ and tissue donations are more important than most of us realize.
“In Nova Scotia, at any given time there are more than 100 people waiting for an organ transplant to live a healthier, more productive life,” he said. “For some, receiving an organ is a matter of life and death. People with end-stage organ failure suffer on a daily basis and are living difficult lives while awaiting a transplant. Some will become too sick to receive a transplant, others will die while waiting.”
Beed said almost all of these people saw themselves as healthy until they got sick, people with acquired disease rather than congenital disease.
“We cannot know our future so this could be the fate of any one of us, even as we sit here in good health,” Beed said.
He said tissue donation from just one person, such as bone, skin, heart valves, tendons or corneas, can renew or save life for as many as 75 people, including burn patients, children with heart problems, the visually impaired and those with mobility problems.
Some Nova Scotians said the new law stepped over ethical boundaries, accusing the government of taking organs and that deemed consent does not constitute a gift or a donation.
“This is not true,” Beed told the health committee. “We continue to urge individuals to make a donation decision, register it and discuss their decision with their families. Someone who wants to give this gift can certainly make that clear as can individuals who do not want to donate after death.”
The government assures that there is no deadline or cut-off for opting out, which can be done by completing or renewing a Nova Scotia health card application.
In other circles, it’s thought that organ donation might be contrary to Catholic Church precepts, but Pope Francis in a 2019 meeting with the Italian Association of Organ Donors said that society needs such concrete gestures of “generous love to make it clear that life is something sacred.”
The only caveat, the Pope said, is that the donation must be for the good of others and not for monetary gain, “an unpaid, free act.”
By giving freely, “we will receive our reward from God according to the sincere and concrete love we have shown toward our neighbour,” Francis said.
Beed, in his newspaper interview, said upgrades to the Nova Scotia organ donation program would cost about $3 million, including 27 new full-time hires. He said that investment would easily pay for itself in increased donations that will take people off the wait list. Beed estimated a single donor giving two kidneys could save the health-care system some $600,000, mainly a reduction in dialysis treatment.
Donations have obvious benefits for organ recipients and those closest to them. Beed, however, contends that the biggest incentive to push for increased donations comes from the comfort families gain from knowing the last gift their loved one made before succumbing to a sudden or expected death is saving and changing the life of another.
“I have never had a family become upset when we discussed donation, even when they chose not to provide consent, but I have had families contact me weeks after a loved one dies, very upset, when they realize that no one asked them about donation and that their loved one would very much have wanted to do that,” Beed said of his 15 years as head of the donation program.
(Campbell is a reporter at the Halifax Chronicle Herald.)