Opinion

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This article was published 29/01/2022 (489 days ago), so information in it may no longer be current.

DISCUSSING the dispersal of our body parts after death is not an uplifting conversation, granted, but a noteworthy landmark has been achieved in the field of organ donations.

On Jan. 18, Nova Scotia marked one year of presumed consent, the first jurisdiction in North America to try this social experiment. It means Nova Scotians are presumed to agree to donate their organs when they die, unless they opt out. It reverses the practice of other places, including Manitoba, where consent isn’t presumed and people must opt in to donate.

Nova Scotia released last week statistics on its first year. In a province of one million people, only 57, 382 people opted out.

Meanwhile, officials have seen a sharp rise in referrals, the term medical officials use to notify each other of potential donors. More than 200 referrals were made for organ donations in 2021, a rise of about 130 per cent over 2020. A total of 1,581 referrals for tissue (skin, corneas, bone) were made in the past year, a rise of 228 per cent.

Nova Scotia’s paradigm shift from opt-in to opt-out is being closely watched by provinces such as Ontario, Quebec, New Brunswick and Alberta that are reconsidering their organ-donation laws.

Manitoba? Not so much. The idea has been previously raised and rejected in this province. In 2017, the Progressive Conservative government of Brian Pallister shot down a private member’s bill by former Manitoba MLA Stephen Fletcher to impose presumed consent for organ donations.

“There are implications for particular religions that want to see their loved ones buried whole,” Brandon West MLA Reg Helwer said at the time, apparently missing the point that people who want to be buried whole can always opt out of presumed consent.

Instead, in 2019, Manitoba stopped sending out paper opt-in cards that people were supposed to keep in their wallet, moving its organ donor registry entirely online for people who chose to opt in and sign up.

Even though the PCs dismissed the prospect of switching to presumed consent, the issue continued to be explored in a 2021 consultation paper by the Manitoba Law Reform Commission. The report aired the issue thoroughly and, rather than making a direct recommendation about whether Manitoba should change The Human Tissue Gift Act, it sought public input about surrounding issues.

Public input on the issue is typically controversial. Some people insist presumed consent is unethical. They say people unaware of a presumed-consent law, including marginalized people, may not understand they have a choice. The Canadian Civil Liberties Association is among groups that have expressed concern that a government is going too far when it makes such decisions about citizens’ bodies.

Ethics aside, public discussion about Nova Scotia’s pioneering legal change has also prompted practical questions as people ponder the implications of their organs being recycled.

Common questions include: can I still be displayed in an open casket if my organs are taken? Yes. Donation does not change the appearance of the body.

Can I sell my organs? No. That’s illegal in Canada.

If doctors are eager to get my organs, will they be less likely to make every possible effort to prolong my life? No. Medical care and organ recovery are done by entirely separate teams. The organs are taken only after all efforts to save the patient’s life have been exhausted.

While it’s true that stigma around death leaves some people feeling skittish about removing body parts, at least 4,400 people wish we’d get over our qualms. That’s the number of Canadians on waiting lists for transplants. Some will die before they get a transplant because this country’s supply can’t meet the demand.

The necessity of a larger supply of organs is particularly important in Manitoba, where an average of 200 people await new kidneys. Data show Manitoba has Canada’s highest rate of end-stage kidney disease, which is often due to diabetes.

Regardless of whether Manitoba ever progresses to the presumed-consent concept, as it should, Manitobans remain free to take it upon themselves to save lives. It takes only minutes to call up the relevant website and register our intent to donate our organs and tissue. The site is signupforlife.ca.

Unfortunately, many people intend to opt in, but few do. Surveys show as many as 90 per cent of Canadians favour the practice in theory, but only about 20 per cent actually give consent.

If one definition of a hero is someone who saves lives, organ donors are heroes. One body has many transplantable parts, which lets a single organ donor save up to eight lives, and a single tissue donor improve the lives of as many as 50 people.

Donating our organs is a way for us to become a living legacy, literally. None of us can live eternally, but our final gift can be helping other people. An admirable end.

carl.degurse.freepress.mb.ca

Carl DeGurse is a member of the Free Press editorial board.