Should people be organ donors by default? A prominent
Ontario opposition politician thinks so, and he's so passionate
about the issue he decided to muscle "presumed consent"
onto the legislative agenda in Queen's Park. On February
16, Peter Kormos, the New Democrat MPP for Niagara Centre,
introduced a private member's bill that he hopes will
make every citizen a potential organ donor unless they
explicitly wish to opt out.
If Ontario were to pass Mr Kormos'
law it would be a radical shift in policy from the current
system, which requires that doctors obtain a patient's
donor card plus the family's consent to harvest organs.
"I became aware of the number of people who are dying
unnecessarily every day while waiting for organs," says
Mr Kormos on what moved him to introduce the controversial
presumed consent bill.
DISMAL
DONOR RATES
In Ontario the donor rate of 13 donors per million population
falls just below the national rate of 14 donors per
million population. With 4,000 patients in Canada waiting
for life-saving transplants, Mr Kormos thinks we've
got to do something about the supply. "I remember the
birth of organ transplants as a medical procedure, and
at one time receiving a transplant was exceptional,"
says Mr Kormos. "Surely now what is exceptional is that
we are burying and burning perfectly good organs that
can save people's lives."
The bill will be debated in the
next legislative session due sometime in the spring.
It was initially introduced last year, but died due
to lack of support. Discussion of presumed consent laws
has been undertaken in Alberta, Manitoba and Quebec,
but, if passed, this bill would make Ontario the first
province to adopt the rules. Presumed consent has been
adopted in more than 20 European countries, including
Spain, Italy, Greece, France and Switzerland, all of
which have seen significant reductions in wait times
for transplant patients. "I think it's an idea whose
time has come," says Mr Kormos.
Dr William Wall, Director of the
Multi-Organ Transplant Program at the London Health
Sciences Centre, agrees with Mr Kormos that something
has got to give in Ontario. "It's a crisis situation,"
he says. "There have never been longer waiting times,
there have never been more people waiting for transplant,
and there have never been more deaths while waiting."
Organ donation rates in Ontario
lag behind other provinces, such as Quebec and the Atlantic
provinces, despite them not having presumed consent
laws either. In 2004, 242 patients died waiting for
life-saving transplants in Canada, with over 120 of
those deaths occurring in Ontario.
ORGAN
LEGENDS
"There are many misconceptions around organ donation,"
according to Dr Wall, and he believes that these fallacies
combine with fear and hinder donation. He is utterly
astounded by the number of people who believe that if
they have an organ donor card, a doctor will not work
as hard to save their life. "There hasn't been a significant
effort to educate the public," he says. "I would only
welcome presumed consent as a part of a solution in
that the public must truly understand the implications
of the legislation through educating them on organ donation
and organ transplant. The legislation should enhance
public opinion about organ donation."
Dr Wall says that southwestern
Ontario has high donor rates compared to the rest of
the province. The London Sciences Centre is one of the
leading transplant programs in the country, with a rate
of organ donation at 26 donors per million population,
almost twice the national average. Dr Wall attributes
this to an educational program that was implemented
in southwestern Ontario high schools five years ago.
As part of the health curriculum, grade 11 students
learn about organ donation and transplant. Dr Wall says
that students ask thoughtful and poignant questions
and often go home and discuss the issues with their
families, thus beginning thoughtful and educated discussion
on donation. It is precisely these types of proactive
outreach programs that he hopes to see more of in the
near future.
HARVESTING
MINDS
Mr Kormos agrees that educating the public is the best
way to increase the rate of organ donation. "I'm not
eager for this particular bill to pass," he says. "I'm
more interested in using the bill, or the debate around
the bill, to encourage discussion and create reform."
Since introducing the bill, Mr
Kormos says feedback from politicians of all parties,
doctors and the public has been overwhelmingly positive.
Next, he hopes to create a select committee involving
all political parties to spend several months studying
different models to encourage donation. While many other
politicians are more comfortable talking about ways
to encourage people to sign donor cards, Mr Kormos says
that's not the answer. He argues that more drastic measures
need to be taken to change the public's attitude toward
organ donation. He wryly notes that the organ donor
card in his wallet is deteriorating.
"We have this attitude that giving
an organ is an act of benevolence," says Mr Kormos.
"I think it should be as normal as brushing your teeth."
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