Opinion: There are more Canadian organ donation supporters than registered Canadian donors

Decades ago, the notion of organ and tissue donation after death was regarded as controversial, particularly in some religious communities.

Times have changed.

When Research Co. and Glacier Media asked Canadians about the topic earlier this month, more than four in five (84 per cent) supported the concept, and only nine per cent were openly opposed to it.

The fact that a large proportion of the population endorses the existence of a policy does not make its adoption universal. We also found that two-thirds of Canadians (68 per cent) would want their organs and tissue donated after their death.

British Columbia and Alberta emerge as the provinces with the highest incidence of prospective organ and tissue donors (71 per cent each), followed by Saskatchewan and Manitoba (69 per cent), Atlantic Canada (also 69 per cent), Quebec (66 per cent) and Ontario (64 per cent).

These numbers could be regarded as fantastic news for people on a waiting list. There is, however, a significant disparity between outlined wishes and the explicit consent usually expressed in a health card or driver’s licence. At this point, only 43 per cent of Canadians say they have registered to be organ and tissue donors after their death.

The gaps are noteworthy on all demographics but are particularly staggering on some. We go from 61 per cent of Canadians aged 18 to 34 considering themselves prospective organ and tissue donors, to only 39 per cent claiming they are actually registered.

The worst performing province when we compare these indicators is British Columbia. Only one third of the province’s residents (33 per cent) remember having provided explicit consent for organ and tissue donation after death, a far cry from the 71 per cent who claim that this is what they want to do.

One way to deal with these differences is to implement an “Active Donor Registration” system for organ and tissue donation after death. Under this system, every person over the age of 18 is considered an organ and tissue donor unless they specifically opt out of a registry.

This policy was first implemented in Spain in 1979 and remains remarkably successful four decades later. Spain, which accounts for 0.6 per cent of the global population, is the country where six per cent of all global organ and tissue donations took place in 2019.

Right now, one Canadian province already has a comparable law in the books. In Nova Scotia, the “Human Organ and Tissue Act” passed unanimously in the House of Assembly and came into effect in January 2021, making every single adult who has resided in the province for at least a year a potential organ and tissue donor after death. If residents do not wish to be donors, they can “opt out” of the system. Lawmakers in New Brunswick are currently considering a similar approach, but no vote in the legislature has been scheduled at this time.

Canadians appear to be ready for this new approach. Almost two-thirds of respondents to our survey (65 per cent) think their province should implement an “Active Donor Registration” system for organ and tissue donation after death.

On a regional basis, support for “Active Donor Registration” is highest in British Columbia (69 per cent), followed by Saskatchewan and Manitoba (68 per cent), Atlantic Canada and Alberta (65 per cent), Quebec (64 per cent) and Ontario (61 per cent). Sizeable majorities of Canadians who voted for the New Democratic Party (74 per cent), the Liberal Party (68 per cent) and the Conservative Party (67 per cent) in the last federal election are also on board.

A quick glance at the latest statistics from the Canadian Institute for Health Information outlines the severity of the situation. In 2021, 2,835 human organs were successfully transplanted in Canada. This still left 4,133 Canadians on a waiting list for a suitable kidney, liver, heart, lung or pancreas, and 252 Canadians who passed away awaiting a procedure.

British Columbia provides a powerful example of the possible success of a new regulatory framework. Practically seven in 10 of the province’s residents endorse both donating their organs and tissue after death and implementing “Active Donor Registration.” Right now, just over two in five British Columbians have explicitly outlined their wishes.

The Government of Nova Scotia is expected to release information about how the “Active Donor Registration” system is performing. This will be an opportunity to learn about how many lives have been saved, as well as the tangible benefits for families and individuals. Nova Scotia’s experience could set an example for other provincial governments, especially in Ontario and Quebec, where perceptions on all aspects related to organ and tissue donation are slightly lower than in other regions of Canada.

Results are based on an online survey conducted from Oct. 15 to Oct. 17, 2022, among 1,000 adults in Canada. The data has been statistically weighted according to Canadian census figures for age, gender and region in Canada. The margin of error – which measures sample variability – is plus or minus 3.1 percentage points, 19 times out of 20.

Mario Canseco is president of Research Co.