A Culture of Health

Make Organ Donation Universal with opt-out system

Right now, people in Canada have to register as organ donors to be recognized as a donor.

Ontario should move to an opt-out system. The evidence is clear - people are patiently waiting for organs and tissues which could significantly improve lives but many are let down by our current system. There is correlation between countries having a donor opt-out system and having a higher number of organ donations. In "opt-out" systems there were increases in the organ donor rate of up to 25%.

Most donations come from patients who have suffered a sudden catastrophic event leading to neurological death (such as a motor vehicle accident), and only a minority of donors are removed from life support and suffer a cardiac death. Families not only have a say in decisions about life support, but they also have the ultimate say on donation, even under presumed consent.

Five things everyone should know about organ donation:

1. There is a dire need for donors

There are approximately 4,500 people on the transplant list. Approximately 250 people on the list die each year while waiting for a transplant.

2. What can be donated?

Surgeons can transplant a person’s heart, lungs, liver, kidneys, pancreas and small intestines. Up to 7 lives can be saved by a single donor.

3. There’s also a need for tissue donation

Although few in-hospital deaths are eligible for organ donation, the majority of patients will be eligible for tissue donation such as corneas, or heart tissue.

4. How to become a donor

There are no longer donor cards in Ontario. Ontario has a website, BeADonor.ca, which lets you sign up to be a donor.

5. Talk to your family

Even if you’ve signed up to be a donor, your family is still given the ultimate choice after you’ve passed, so it is important that if you want your organs donated, to talk to your family about your wishes.

Countries which have the most donors combined the introduction of their opt-out system with other changes, like better infrastructure, more funding for transplant programmes and more staff working to identify and build relationships with potential donors before their death. Spain is often touted as an opt-out scheme success story. Presumed consent with opt-out legislation was passed in 1979. The legislation is patient-centred and family focused, as they are consulted and have the final say.

Meanwhile, organ donation in Ontario is offered as an opportunity to families of patients who have died by neurological criteria or in whom invasive physiologic support (e.g. ventilation, vasopressors, etc.) will be withdrawn (donation after death by circulatory criteria). Tissue donation is offered to all eligible patients who die in a hospital in Ontario. We know that organ donation has a beneficial impact on bereavement. Organ donation gives families of the deceased an opportunity for some good to come from the tragedy, for the last wishes of their loved ones to be honoured and lives to be saved.

A 2009 review published in the British Medical Journal found that donation rates rose by nearly 25 per cent after implementation of presumed consent policies in certain countries. However, other factors such as public awareness campaigns and increased resources for organ donation and transplantation likely played important roles as well.


Source: https://www.ncbi.nlm.nih.gov/books/NBK56888/



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Idea No. 60