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The Current Transcript for January 6, 2017

Host: Piya Chattopadhyay

STORIES FROM THIS EPISODE

Listen to the full episode

Prologue

[Music: Theme]

SOUNDCLIP

In 2019, when they realize that they were promised a lot of sunny ways and sunshine and unicorns and carebear economics, that the jobs just aren't there. We need a leader who can bring that positive vision of what conservative values do to a broader audience of Canadians.

PIYA CHATTOPADHYAY: That's Andrew Scheer, one of the baker’s dozen of declared candidates fighting to lead the Conservative Party of Canada into the future. After almost a decade in power under Stephen Harper, the Tories are back in opposition and find themselves opposing a popular PM. So who's best to take up the mantle and take on Justin Trudeau? And more important, how should the party position itself in the post-Harper era? Some conservative strategists are here to share their thoughts in just a few moments. After that..

SOUNDCLIP

Some people call it the citizens dividend, other people call it the basic income. How I like to call it — free money for everyone.

PC: The universal basic income may be a utopian idea, but it's being put into practice this year in Finland, Oakland, California, and it's even coming to Ontario in a pilot project. Supporters say it will ultimately keep government spending down, helping with health care and education. Others say receiving a check just for breathing sends the wrong message. More on the basic income in half an hour. Plus, shouldn’t we change our current system so that unless we say otherwise, every one of us is presumed to be an organ donor?

SOUNDCLIP

Every breath I take, I take it for my donor and donor family. I'm here because of a very tragic time in someone's life. They looked beyond that tragedy and decided to make that incredible decision.

PC: We'll talk about the decision to be an organ donor in an hour. Hi, I'm Piya Chattopadhyay and this is the Friday edition of The Current.

Back To Top »

Conservatives clash in fight to re-define party after Stephen Harper

Guests: Ginny Movat, Gerry Nicholls, Tim Powers

SOUNDCLIP

Today we have two leadership candidates that actually threaten the path to victory. Kevin O’Leary and Kellie Leitch are embracing elements of Donald Trump's campaign, while ignoring others. Kevin O'Leary and Kellie Leitch are both taking lessons from what we saw just recently in the US election. And they're embracing a style of negative, and I would say, irresponsible populism.

PIYA CHATTOPADHYAY: Well, it's a crowded field in the race to become the Conservative Party of Canada's next leader. But as that clip from candidate Lisa Raitt illustrates, there are at least a couple of possibles getting the lion's share of attention. They include former cabinet minister Kellie Leitch and the businessman and reality TV personality Kevin O'Leary. Never mind that he has not formally entered the race, at least not yet. Thirteen candidates have made their bids official and with the election set for this May, it's not just the Conservative leadership that's up for grabs, it is the very direction and brand of the party in a post-Stephen Harper era. We have three conservative strategists standing by with their thoughts on where the party is going and how best to position itself to take on Prime Minister Justin Trudeau and the Liberals. Ginny Movat is a Senior Consultant with Crestview Strategy. Gerry Nicholls is a Communications Consultant and a long time strategist. They're both here with me in Toronto. And Tim Powers is with Summa Strategies. He's in Ottawa. Hello to all three of you.

MANY VOICES: Good morning.

PC: Tim, let me begin with you. You know, there’s--

TIM POWERS: You want to talk to me Piya because I'm stuck in a closet here in Ottawa. Don't build off that metaphor either.

PC: OK. Alright, not going there. But I want [chuckles] to ask about that clip we just heard from Lisa Raitt, because there she is naming names. What's your reaction when you heard her go after Kellie Leitch and Kevin O'Leary?

TIM POWERS: Well, Lisa wants to bait the shark. If you look at Mr. O'Leary of course as the shark, because engaging in that debate means she gets elevated, part and parcel. If Kevin O'Leary, as you described, and I think you're right, is the most talked about potential candidate, well, what better to do in a crowded field where nobody's broken out than to become the nemesis of the shark or the chum that the shark is going to go after? Also I think in this case, in an era where we're talking about fake news, Lisa actually believes in what she's saying and what she has heard about Kevin O’Leary, so I think that's her strategy there. It's not without risk, because not unlike what happened in the US, though I would suggest comparisons generally are not perfect. She could reinforce some of the perceptions people have about Kevin O'Leary as the outside disruptor that the Conservative Party needs.

PC: OK, Gerry Nicholls, let's pick up on what Tim just said there but also what Lisa Raitt used to describe Leitch and O'Leary's brand, if I can put it that way. She called it irresponsible populism, comparing their tactics to President-elect Donald Trump. What do you make of Lisa Raitt’s assessment, you know, throwing around the word irresponsible populism?

GERRY NICHOLLS: Well, you know, there's a saying in the military, if something’s stupid but works then it isn't stupid. And I think the judgment and whether or not it's irresponsible, it will be determined after the race is over. If Kellie Leitch wins, then it's good strategy.

PC: [laughs]

GERRY NICHOLLS: What she's doing is the right thing. If she loses then we can say it's irresponsible. Look, you know, I think the colossus over this race right now is Donald Trump, right? I always say Donald Trump is the Christopher Columbus of politics, in that he made a very important discovery by accident. And what he's discovered is that regular run of the mill politicians are no match for reality TV stars. And Kevin O'Leary is a reality TV star, so he kind of fits that Donald Trump, you know, template pretty well. And I think Raitt realizes that, I think she sees if he comes in the race he's an instant frontrunner. So she's doing a pre-emptive attack. And I think what she's trying to do, you know, just to build on what Tim said, she is trying to sort of create awareness for herself by defining herself as the anti-Trump, as the anti-Leitch, as the anti-O’Leary.

PC: OK. Ginny Movat, come in here. This is a tactic that as Gerry says it works if you win, it doesn't work if you don't win. Where are you on this strategy that Lisa Raitt is using to an extent? At least suggesting or positioning herself as different from the Leitches and O'Learys saying they are Donald Trump-style politicians.

GINNY MOVAT: Yeah, I mean, I don't know that the Republican nomination is a perfect comparison, for a lot of reasons. There are a couple that I would point out. One is the establishment is more powerful in this race than it was in the Republican nomination, just by matters of practicality. Donald Trump was able to convince people to vote for him on the day of specific primaries, where there wasn’t, you know, what you would have heard to as a membership cut off that we have here. Where, you know, not only do Kellie Leitch and Kevin O'Leary need to convince people to vote for them, they need to convince them to buy memberships early on before that cut off. And then to also show up on the leadership election day and vote for them. And that that wasn't a huge obstacle for Trump in his nomination. In fact, the Republican establishment is looking at changing those rules so that very thing can’t happen again.

GERRY NICHOLLS: Too late.

GINNY MOVAT: But for better or for worse, I mean, they're different systems. But that doesn't mean that we should underestimate Kevin O’Leary or Kellie Leitch. And I think that while I understand the logic of trying to get in early, you know, Chris Christie, Marco Rubio, others who tried to go after Trump too late in the game, where maybe lost because of it. And I think the logic here is Lisa saying I want to get in early and get my hits in early and try to damage their brand before it's too late and they run away with it.

PC: OK. I want to talk about, and we'll like round this in in our country and Canadian politics and talk us sort of about the identity issues this party may or may not be facing. So Gerry Nicholls, how does the fight or the debate between the 13 declared candidates and Kevin O'Leary perhaps, symbolize the larger identity issues facing the Conservative Party of Canada today?

GERRY NICHOLLS: Well, I always say, you know, it's a misnomer to, you know, to say it's a Conservative party. What it really is is a loose coalition of tribes, clans and factions that probably hate each other as much as they hate the Liberals and the NDP.

GINNY MOVAT: [laughs]

GERRY NICHOLLS: One of Stephen Harper's sort of underestimated skills as leader was he kept these fractious groups united, you know, through iron discipline. But he did it, he kept those guys under that banner. Harper's gone though. And now that Harper's gone, sort of the driving centralized intelligence of the party is gone and the danger is that it could break up into its component parts. And I think that's what we're kind of seeing happen right now. We have Maxime Bernier is the libertarian tribal chieftain. And you have Brad Trost is a social conservative. You have Kellie Leitch as the populist nationalist, as we're just talking about. You have Chong as kind of the Red Tory candidate. You have all these sort of groups going after each other. What the Conservative Party race lacks right now is what I would call a Lord of the Rings candidate.

GINNY MOVAT: [chuckles]

GERRY NICHOLLS: You know, someone to rule them all. That's what they're missing. And this is the danger for the party. When this race is over, will whoever wins, whoever it is, will he be able to sort of weld this sort of disparate group together again?

PC: Ginny Movat, Gerry’s suggesting there's a lot of ideologies, a lot of different ways to go here. What is at the core of all this? I mean, what are the larger identity issues beyond what Gerry’s saying, it’s just a lot of people representing different parts of this party. What is it facing?

GINNY MOVAT: Yeah, I'm not sure, I accept that there are some activists within the party who self-identify with those kind of labels, but I don't think the average party member or certainly who we should be aspiring to sell memberships to would identify in that way. I think the average voter who might consider voting, maybe they voted for Stephen Harper when he won a majority, has a set of issues that they care about and very personally, and they're are often pocketbook issues, they often have to do with their families. And I don't, I mean, those labels matter to activists and they matter to the kind of people who go around and work on leadership campaigns and sell memberships, but not necessarily the people that we want to buy them, to grow our party. So Gerry's right in that what we need is someone who will reach out to groups beyond those factions, to sort of average everyday people, who sometimes buy party membership, sometimes don't. And who maybe are a little bit dissatisfied with Justin Trudeau, maybe they even voted for him, but they're not thrilled with how he's handled things over the last year. And who are open to voting Conservative if they can be convinced to.

PC: Tim, where are you on this one? Where is this party ideologically in 2017?

TIM POWERS: Well, I'm no J.R.R Tolkien first of all, so I won't invoke the Lord of the Rings analogy. I'm not sure that's a good one because the Nazis liked that one as well too and that's what inspired Tolkien, but, and we don't want the Liberals to know that, you've given them too much information this morning Gerry. But I think this is part of the natural transition that happens after a Conservative party has governed though too. You go back in the history of when conservative parties have governed, and they tend to be built around the strengths and weaknesses of whatever the particular leader is of that era and what he or she and the she in the Conservative Party was not successful, Kim Campbell I'm talking about, and how they built the party at the time. So Gerry's analogy is right, it's usually a loose association of different tribes and clans. And I think we're starting to see that again. I mean, there is an upside in all of this discussion and debate, though some of it is certainly off putting to Canadians. And it is showing proof of life. And I think Canadians do want to see some value in their opposition, that there is a proof of life that is having a healthy discussion about what it wants to be in juxtaposition to the Liberal government. So the, you know, the benefit of Lisa throwing a few punches this week is we're not quite that junior hockey game of last night in the Conservative Party, but there's a bit more excitement and there should be transition, and there should be change, and there shouldn't be a homogenous identity because political parties are living, evolving organisms and this one is certainly one of those things.

PC: OK. I want to play a bit of tape. This is Chris Alexander, one of the leadership candidates. This was from late last year, made a lot of news, when he was speaking and the crowd starts chanting lock her up, the references to Alberta Premier Rachel Notley. So let's just take a listen to that.

SOUNDCLIP

CHRIS ALEXANDER: When I heard it I was actually mortified, because I don't ever think our democracy should be associated with calls for illegal unconstitutional action. Do I wish that the chant did not happen? Yes. But at the same time, I take the anger and frustration of the people who were there very seriously.

PC: So there's one thing to talk about the leadership candidates, and as Ginny suggested, you've got to talk about the members and what they want and what they're saying on the ground. So Ginny, how seriously should the Conservative Party be talking about the anger that Chris Alexander says is out there?

GINNY MOVAT: It's out there. Particularly in Alberta, which is where that chant happened. But I don't think that that's enough. Those group of people who are angry, voting Conservative next time and voting in the leadership, those people are not enough to give the Conservatives power and to give them even a minority of seats, I think, or a plurality of seats rather. So you can't alienate them, and I think Chris is right in that he, you know, you can't you can't talk down to them, you can't brush them off, you can't dismiss them or that feeling. But to focus only on that anger I think is not reflective of the voter we need to aspire to if we're going to win back government.

PC: Tim Powers, are those people representative, who are chanting lock her up, of the Conservative base or a proportion of them?

TIM POWERS: God let's hope not. But I think what you're seeing, and I know this is morning radio Piya, so pardon this expression, but people do pander to the pissed off. And there are people out there that are angry for different reasons, whether it be their pocketbook in Alberta because of policies they believe Rachel Notley's brought in that are harmful to them, or other policies that they point to the government in power of the day of being detrimental to their well-being. So you don't get to be prime minister until you become Conservative leader first, and I think, you know, in the case of Kellie Leitch and perhaps some others, they're trying to galvanize enough angry people to do step one first, which is to become the leader of the Conservative party then to change in some degree way or fashion how they will go forward afterwards, because you can't win with just 27 or 28 per cent of the Canadian public who identify as Conservatives, you need about 37 or 38 per cent. But you can't also get to be prime minister until you become Conservative leader first, and to do that sometimes a delimited strategy focusing on people's anger can work, and that's certainly the Leitch game plan.

PC: OK. Do you want to say anything on this one Gerry?

GERRY NICHOLLS: Well, yeah, the two most important emotions in politics are hate and fear.

TIM POWERS: Mmhmm.

GERRY NICHOLLS: OK? And if you can harness those emotions, if you can get some kind of issue that has that emotional heat to it, it can take you a long way.

PC: OK. Peeling back the curtain on strategy there, thank you for that. It makes me feel unsettled.

GERRY NICHOLLS: Yeah, I'm sorry I had to do that.

PC: Let's talk about Kevin O'Leary. As I said, he has not declared his candidacy. You all think he will. I'm looking at Ginny and Gerry and Tim.

GINNY MOVAT: I think he’s serious, yeah.

TIM POWERS: Tim, is he serious? Is he entering this thing?

TIM POWERS: I didn’t think he was, but I've moved into the camp where I think he's almost there. I think if he were going to say yes he would, well, he doesn't want to say it before the French debate but, you know, the comparison I think that fits for O’Leary, it's one I've tried to invoke, and I don't have a candidate in this race, I don't know if my colleagues do, but he reminds me more of Ignatieff than he does of Trump. And I think that's dangerous. He's had a success in the United States, he's seemingly believing a lot of the press clippings from conservative fawning columnists about his invincibility. He seems to believe that leadership alone without necessarily working the ground can win. Maybe that will all be disproven, I hope in fact it is. But Kevin ought to be careful to learn the political lessons of Canada in the past, not just America.

PC: And just to give people a sense. I mean, not running yet, but to give people a sense of what a Kevin O’Leary official campaign, should it become that, sounds like. I want to play a bit of an unofficial campaign is sounding like.

SOUNDCLIP

Canada’s a mess, it really is. When the rest of the world is getting more competitive, our leadership and Justin Trudeau has gone in wrong direction. We're raising taxes, we have a faulty carbon tax program going into place January 1st, we're losing jobs by the hundreds of thousands. Most Canadians know this is an absolute mess. We're going to have to take a big spatula to Ottawa and scrape all that crap out.

PC: I have to say in that video Kevin O’Leary--

TIM POWERS: Piya, what’s a spatula by the way?

PC: Well, he’s actually holding up a spatula in that video. If you don't know what a spatula is Tim, you should spend more time in the kitchen.

TIM POWERS: [laughs]

PC: Ginny Movat, after the Conservatives, you know, lost the last election, there was talk and maybe I shouldn’t use the words sunnier, kinder approach to politics. When you listen to Kevin O’Leary, is that still a priority for the party?

GINNY MOVAT: What sticks out to me when I listen to Kevin O'Leary in that clip is that he's a telegenetic person that understands how to speak in a way that cuts through, and that sounds like he's speaking to average people in a way that they understand, in a way they can relate to. That's something that Donald Trump was really good at and it's also something that Justin Trudeau is good at. Justin Trudeau is very telegenetic and whoever goes up against him will need to be able to come through on television monitors in a flattering, positive way. So not only does Kevin O'Leary know how to be on TV, but he knows how to write lines for himself that cut through. And that's a huge asset for him. The question is is he serious about a broad range of policy issues that matter to conservatives? Again, another difference from the American election, he has to be opposition leader first. Whoever wins this race has to be opposition leader first. Donald Trump was either going to win or lose, he was either going to be president or not. But these guys need to be opposition leader, they need to be in the house every single day, they need to understand parliamentary procedure. And it's hard right now to imagine Kevin O'Leary in that role, for me.

PC: Gerry Nicholls, help me out here. In terms of the grander party, if you will, what questions should the Conservative party be asking itself right now?

GERRY NICHOLLS: How can we beat Justin Trudeau?

TIM POWERS: Mmhmm.

GERRY NICHOLLS: I mean, that's, you know, that's what it boils down to. And I think this is kind of the message that Kevin O'Leary is delivering. He's saying I'm going to beat this guy, I’m going to beat this punk. And he's doing, as Ginny says, he's doing it in language that, you know, that people can relate to, and I think that kind of excites the Conservative base, because hey, we want to win. That's what really this is all about, it's not about ideology, and I don't think it's even about issues. You know, people don't really care about issues in politics, I know that sounds silly but it's true. The things that O'Leary brings to the table, which give him strength I think are a couple of things. First of all, his personality. He's got a very interesting personality, you know, it attracts a lot of media attention, in that way he's kind of like Trump. And the second thing is he has a defined role in the play, and that's always important. I always tell people who are running, you have to figure out who you are in the play, who are you in this theatre? And he is businessman, which is one thing the Conservatives don't have right now, he is businessman. And if I was advising O'Leary, I would say to him only thing you should be talking about issues is define your character. Only talk about economics.

PC: Are you advising O’Leary?

GERRY NICHOLLS: No. He should hire me.

TIM POWERS: [laughs]

PC: That wasn’t the point.

GERRY NICHOLLS: He should only talk about economics, he should only talk about fiscal issues. And every sentence should start with, as a businessman. As a businessman I know how to cut taxes, as a businessman I know how to balance the budget. If he can stick to that message, I think he could be pretty successful.

TIM POWERS: Except to Gerry's point, you also have to wear the right costume and appearing, putting out, referring to yourself first of all in the third person as Mr. Wonderful doesn't really help with humble Conservative voters. Appearing on Christmas Eve in your robe, opening a champagne bottle with a flute and championing that really isn't good for the brand. And to Ginny's point, Kevin may be very comfortable in Muskoka and God bless him for being comfortable in Muskoka. But I want to see how he eats donuts in Mount Pearl. You know, he's got to learn some of those things. That doesn't mean he can't. But he's also got to transition because as Ginny rightly points out, it's three years before there’s a next election. That's a lot of time in church basements, in coffee shops and not so glamorous places talking to people. You don't win federal elections in the air, you win them on the ground. Kevin has to demonstrate he has those chops, if he's serious.

PC: I've got to let the three of you go. But just quickly, and you really get to name names here if you want. If you're voting today, who would you pick? Ginny.

GINNY MOVAT: I think to Gerry's point about one ring to rule them all. I think right now the closest to that is Andrew Scheer.

PC: Gerry.

GERRY NICHOLLS: I'm a libertarian, so I’d favour Maxime Bernier I think.

PC: And Tim.

TIM POWERS: I'll give you three choices, Bernier, Raitt and Scheer are kind of who I'm thinking about at the moment.

PC: We shall see come May. Thank you all three of you.

TIM POWERS: Thank you.

PC: Ginny Movat is a Senior Consultant with Crestview Strategy Gerry Nicholls is a Communications Consultant, long time strategist. They're both here with me in Toronto. Tim Powers is a conservative strategist with Summa Strategies. He was in Ottawa. The CBC News is next. And then we'll bring you another in our series of personal moments of disruption, one that started with a cryptic message. That's coming up in our next half hour. I'm here Piya Chattopadhyay, you're listening to the Friday edition of The Current.

[Music: Extro]

Back To Top »

Scott Riley and his improbable path to a decades-long goal

Guests: Scott Riley

PIYA CHATTOPADHAY: Hi, I'm Piya Chattopadhyay and you're listening to the Friday edition of The Current.

[Music: Theme]

PC: Still to come, the basics on the universal basic income and why places including Finland and Ontario are giving it a try. We'll talk about that later this half hour. Plus, we're asking whether the time has come for presumed consent when it comes to organ donation. We'll have that discussion in half an hour. But first, a journey of discovery with a disruptive twist.

[Music: The Disruptors Theme]

PC: When your life is disrupted, it usually comes as a surprise. But Scott Riley knew how he wanted his life to be disrupted and had to wait half a lifetime for it to happen. His personal moment of disruption story now is part of our season-long project, The Disruptors. The Current’s Julian Uzielli takes it from here.

[Music: somber ambient tones]

SCOTT RILEY: I was adopted in 1976 with my twin brother.

JULIAN UZIELLI: This is Scott Riley.

SCOTT RILEY: My birth mother and birth father were very young, they were about 15 or 16 years old.

JULIAN UZIELLI: Scott lives in Dundas, Ontario just outside Hamilton, with his wife and two kids. And for the majority of his life he had no idea who his birth parents were.

SCOTT RILEY: There was pressure from both sides of the family to give us up. I think there's a certain amount of shame, it being the seventies and not married out of wedlock. It was still somewhat taboo for that to happen.

JULIAN UZIELLI: When he was a kid, Scott I always knew he was adopted but not much else. Until recently, adoption laws in Ontario made it impossible for him to get any official information about his parents.

SCOTT RILEY: I mean, I wanted to know obviously, the classic why was I adopted? What my family history was, did I have any other siblings out there? Who they were as people? Medically, what is my past like?

JULIAN UZIELLI: There were practical questions but also emotional ones.

SCOTT RILEY: There was always a hole in my heart. I wanted to find out who I was, where I came from.

[Music: spacey electronic beats]

JULIAN UZIELLI: Scott didn't have the easiest childhood. His adoptive father left his adoptive mother because of her alcoholism, which eventually killed her. So Scott was raised by a single dad, not a common family arrangement in the 1980s. His dad was always supportive of Scott finding out more about his birth parents. But without any information about them or a way to find them, Scott didn't know where to begin. But in 2008, Ontario changed its adoption laws so that adopted children could request information about the identity of their biological parents.

SCOTT RILEY: When the records came open, I signed out this sort of access to information form saying I would love to be, this is who I am, and I would love to make contact if possible.

JULIAN UZIELLI: So Scott filled out the paperwork and reached out to his birth parents. His parents got together and wrote back. They wanted to meet him too. But Scott never received that letter, because it turned out when he filed his paperwork he had made a mistake on the return address. And so you didn't realize that at first then that they didn't have your correct address?

SCOTT RILEY: No, I had no idea. I guess I was crestfallen as well, because not realizing that they didn't have the right address, I guess not hearing from them, it was sad to think that maybe they didn't want to contact me as well.

JULIAN UZIELLI: When you decided to reach out to them what were you hoping for?

SCOTT RILEY: I was hoping for a big hi. I was hoping for I guess the dream of any adopted person, that there would be a warm welcome hello and a it would be great to meet you. And when I didn't hear a response after a while, I guess, you know, it kind of work both ways. I was crestfallen as well. I was kind of like wow, I guess they don't want to meet.

JULIAN UZIELLI: So Scott moved on with his life and years went by. But in that time he didn't stop thinking about his birth parents, especially when he had kids of his own.

SCOTT RILEY: There was a definite longing. I think I'd even felt more, you know, being a father, you want to know what your kid, what the background is and what your children may or may not be susceptible to or what they may or may not get. So yeah, it was I would say, once I became a father, it was even more paramount.

JULIAN UZIELLI: But Scott had already reached out through the government. When he didn't hear back from his birth parents he thought that was it.

SCOTT RILEY: But then my twin brother's wife received a LinkedIn request from somebody.

JULIAN UZIELLI: The message said.

SCOTT RILEY: I am a friend of your birth parents and I know who they are. And if you would like to find out more please contact me.

[Music: spacey ambient sounds]

JULIAN UZIELLI: The way this friend managed to find them was because of an article in the wedding section of The National Post. The story was about Scott's brother and how he met his wife, and of course it used their names. So the friend saw the article and got in touch.

SCOTT RILEY: I was totally, totally blown away. I was just like is this real? The one thing she did make clear though is that she actually did this without my birth mother or birth father knowing. She made contact without really, without their consent.

JULIAN UZIELLI: Not long after that, Scott and his brother were able to get in touch with their birth parents for the first time. They set up a face to face meeting at a park.

SCOTT RILEY: We met in Oakville at George's Square. It's weird because I used to live in Oakville growing up and my twin brother and I used to ride our bikes around there. So it was very surreal. But I remember my twin brother and I we arrived together. We passed by a woman in a car with her head down and her hair covering her face, and right away I'm like that's who she is. So we turned around and we all ended up being early and a little few minutes later, another call car pulled up and it was my birth father. So we saw them get out of the car and I looked at my twin brother and he looked at me and I’m like we ready to do this? And we're like yeah. So I went up and I hugged them.

[Music: electronic organ sounds]

SCOTT RILEY: And it was so surreal. I mean, it was a sort of a fairy tale moment that I was actually meeting these people. I felt a thousand different things but the one simple thing I felt was finally. And I felt a certain peace in it. I felt there was a certain amount of rest that came to my heart. The constant yearning and wanting to know just sort of stops.

[Sound: chimes]

JULIAN UZIELLI: When Scott's mother first found out her friend had contacted Scott and his brother she was really angry. She felt her friend had abused her trust and gone behind her back. And they actually stopped talking because of it. But she did want to meet her sons and when they finally met they wanted to know everything about each other.

SCOTT RILEY: We sat down for about maybe an hour, hour and a half, finding out about, you know, family history, finding out about siblings, about my birth parents’ brothers and sisters. And then my birth mother said why don't we go and continue this at a coffee shop nearby? We got into my birth mother's car and my birth mother jokingly, I was taking a little while, and she said Scott get in the car, like somebody would at like, you know, [chuckles[ being like a five-year-old. So and once we all got in the car, there was that surreal moment of my birth mother and my birth dad in the front seat and my twin brother and I in the backseat. And it was just like is this really happening right now? It was incredible.

JULIAN UZIELLI: They went on to the coffee shop and kept talking for several more hours and after a while the conversation turned to work.

SCOTT RILEY: I was actually applying for a job at an automotive plant and I was in the midst of getting hired there and I found out that my birth father had actually worked there for 30 years.

JULIAN UZIELLI: So did you end up working together?

SCOTT RILEY: No, we were actually opposite shifts but we would see each other during shift change over. And there were, actually, there were a couple shifts we did end up working together and he would come on by, and it was, I mean, that alone was incredible, to think that we'd be working at the same place.

[Music: soft piano]

SCOTT RILEY: Looking at him and him looking at me, it was, [chuckles] it was to say the least was incredible.

JULIAN UZIELLI: All this happened about two years ago. Scott doesn't work at that plant anymore but he still keeps in touch with his birth parents. He says he still talks to his birth father about one or two times a month and he gets along pretty well with his new extended family.

SCOTT RILEY: They are one giant hug.

JULIAN UZIELLI: He talks less with his mother mainly because her other kids don't know about her past. Scott respects that and she says she does intend to tell them all eventually but their family’s not ready for that kind of disruption yet.

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PC: That's The Current’s Julian Uzielli, with Scott Riley's moment of disruption. By the way, we're always looking for more stories to tell. If your life was suddenly disrupted in some way, big or small, for good or for ill, we do want to hear about it. You can tell us about it by sending us an e-mail. Go to our website, cbc.ca/thecurrent. Once you’re there, click on the Contact link and be sure to put moment of disruption in the subject line.

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Ontario considers the benefits of basic minimum income

Guests: Guy Standing

[Music: electronic guitar rock tunes]

PIYA CHATTOPADHYAY: I’m Piya Chattopadhyay and this is the Friday edition of The Current.

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Poverty is the best predictor of ending up in prison, which is very expensive and about 120,000 a year per person. Poverty is the best predictor of dropping out of school early. It's the best predictor of bad health outcomes. It's the best predictor of family violence. Therefore, if we are able to reduce the level of poverty, we can save money in other areas and also reduce some of these negative pathologies which are very costly to our economy and to taxpayers generally.

PC: That is former Conservative Senator Hugh Segal. The solution to poverty he's promoting, it's an old idea, but one that has been getting a lot of attention again lately. It's universal basic income, and the Ontario government is preparing to launch a pilot project to test it out later this year. In Europe, Finland started sending out cheques as part of an experiment just this week. The government's going to provide 2,000 of its unemployed citizens with a basic income. It's 550 euros or about 785 dollars Canadian each and every month. And there are more basic income pilot projects on the way in places including California and the Netherlands. A guaranteed basic income is something our next guest has been researching and promoting for three decades now, and it's something that he says can even improve the political climate. Guy Standing is the founder of the Basic Income Earth Network. He's a Professor of Development Studies at the University of London School of Oriental and African Studies. We've reached him today in Geneva, Switzerland. Hello.

GUY STANDING: Hello, it’s nice to be talking to you.

PC: Thank you very much for joining us. First of all, just set this up for us. In its generalities, what is a basic universal income?

GUY STANDING: Well, the basic idea is that everybody as a citizen, a legal resident of Canada or wherever, would receive each month a regular amount, a modest amount, without conditions, paid individually, on which they would be able to make decisions about their lives. And there are various reasons why it is desirable to move to a social protection system, which at its base would have a basic income. That's the fundamental starting point.

PC: So this has everyone? This isn’t if you're unemployed you get a cheque and if you're employed you don't. This is everyone gets this basic income?

GUY STANDING: It’d be regardless of gender, marital status, household status, work status, and income. You can tax back the income from the wealthy by raising marginal taxes, but we can pay for it in various ways. It's eminently affordable.

PC: Would you lose the income in the way you see it, if you get a job, for instance, if you get a high paying job do you then lose a basic income?

GUY STANDING: No. One of the advantages of having a basic income is it would overcome the existing poverty traps, which are huge in Canada, they’re huge in Britain, they’re huge in the United States. A poverty trap arises because if you target your benefits to the poor and only the poor, what it means is if you go from benefits into the sort of low wage jobs that are multiplying, you effectively face a marginal tax rate which might be 80 per cent or more, and with the delays in systems, you can easily end up worse off if you take short term jobs and then you fall back into the benefits system. So at the moment, we have a huge disincentive to people taking low wage jobs. If you had a basic income, you would not lose it. You would have it as a permanent right and any earned income you have, where you would be paying the standard rate of tax on that income and it would therefore give much greater incentive to people to take the available low wage jobs.

PC: Let us talk about a couple, because I mentioned Finland, and I'll ask you about that in a sec. And the Ontario government is going to do a pilot project this year. But let's talk about where there are examples of this being successful. What can you point to?

GUY STANDING: Well, we've done pilots in Africa and we've done a big pilot in India in Madhya Pradesh, where thousands of people, men, women and children were each paid an individual basic income, which was about 40 per cent of subsistence. And then we monitored what happened over the course of two years and compared what their experience was with 6,000 other people, otherwise similar people, who were not receiving the basic income. And we produced the results in a in a big book and the results can be summarized very clearly, very easily. First of all, the welfare effects were dramatic. People improved the nutrition for their children, health, health care, sanitation and the schooling attendance and schooling achievements went up as a result of people having basic security and being able to buy clothes and books and things like that. The second round of effects is that the equity was improved dramatically, because the disabled benefited more than others. Women more than men and scheduled tribes, the poorest of the poor benefited more than anybody else, so it reduced inequities. The third effect, which is very important for critics and supporters to understand is that having basic security increases work not decreases work. People worked more, they were more productive in their work, they took more entrepreneurial risks. And this is a lesson that Canadians can understand as well as anybody else. And the outcome was that earned incomes increased and inequality of incomes decreased and the general economic dynamism of the communities was improved. And the final effect, which was somewhat more surprising to us, is that the emancipatory the value of a basic income is greater than the money value. In other words, it enabled people to have a greater sense of control over their lives and therefore take strategic decisions, not fall into the traps of money lenders and not fall into the traps of dealing with short term expediencies by borrowing at high rates of interest, things like that.

PC: OK. So that's how it worked out in India. But let's look at Finland, a western democracy that's trying this experiment, it is just starting. What results are you hoping to see there and how do you measure success when it comes to Finland?

GUY STANDING: Well I've been fortunate enough to be advising both the Finland government and the Y Combinator people in California who are about to launch this thing. And I've also been interacting with Hugh Segal, who you quoted earlier. And therefore I am seeing these designs evolve. None of them are entirely a full basic income in the way we would like, but each of them are testing different things. One of the limitations of the Finnish experiment is that they're only providing the basic income payments to the unemployed. And what they're really testing there is that supposing you take away conditionality, you don't require people to turn up to bureaucrats and explain themselves and say what they're doing about searching for jobs and so on, they're left to make decisions for themselves. And that we believe, and certainly there's a lot of research to show for it, that the normal human condition is you want to improve your life. So even if you get a basic income, you're going to go out and try and improve that and earn as good an income as you can. You'll have one or two bad apples but the cost of administering and chasing up people and forcing them through sanctions and all that stuff that goes on in Canada and everywhere else is ridiculously high compared with the actual effects. So I believe what we'll see in the Finnish experiment, and it's too early to say what will happen, is that you'll find that people will have a greater degree of confidence, they know they'll be getting that basic income and they will be finding jobs and working and retraining and things like that.

PC: OK. Guy Standing, let me put the criticisms to you, which you've heard before. Logistical ones, logistical questions, how do governments afford to give everyone a basic income?

GUY STANDING: Well, as I've explained in my books, there are several ways of paying for it. One, you can cut back on the huge array of subsidies that governments pay out to the rich, to rich corporations, to elites and middle income groups, which cost the exchequers huge amounts. You could phase that out to the advantage of the economy and to be using that money to pay for a basic income. The second way is you can establish sovereign wealth funds. Now, they've done that in Alaska. The Alaska Permanent Fund, which was set up in 1976 and is gradually being built up. And in Alaska, every year, every legal resident of Alaska receives what is in effect a basic income. An even better system is the Norwegian fund from North Sea oil. But you don't have to use the funds just from oil or minerals, you can use it for me from rental incomes, on intellectual property and so on. And I've advocated that measure. And finally, of course, you're going to be substituting a basic income for some of the benefits, means tested benefits that are inefficient and much of it doesn't go to the poor or needy. So you’ve got a variety of sources of money and of course, at the top of that, you can raise taxes because earlier in our histories, we had much higher tax rates. At the moment, we have ridiculously low tax rates on corporation taxes, on capital and so on. So I think there are plenty of means of paying for it, it's a matter of the transition and moving in that direction.

PC: OK. Before I let you go, because you bring this point up that having a universal basic income is tied to our political climate of today in many countries. So explain how income security, how you see the connection to the rise of far right or politicians and politics?

GUY STANDING: Well, I've argued for a long time that the main reasons for moving to a basic income are a matter of social justice and enhanced freedom and providing people with basic security. And basic security in the precariat, the group I've been writing about, the growing mass class of people in insecure circumstances. If you had chronic insecurity, people become resentful, angry, anxious, alienated and they tend to listen to the voices of the far right political people like Donald Trump, like the Brexit supporters in Britain, like numerous far right politicians across Europe today. And I've been very strongly arguing for the last five years saying in books in 2011, that unless the insecurities of the precariat were addressed, we were going to see the emergence of a political monster of the far right. And I think that argument is resonating with a lot of people, that's why I'm getting invited to Davos of all places to speak about basic income. And we've seen Donald Trump emerge as the latest leader of that drift. And I think many people are realizing that unless we give people, ordinary people, men, women, children, a sense of basic security in which they can have some sense of control of their lives, we're going to see this drift to far right authoritarian figures like Marine Le Pen in France and that's going to be very dangerous. So in a sense, one could say that of all the other arguments, now basic income is almost becoming a political imperative.

PC: Guy Standing, thank you for your take on all this. Appreciate it.

GUY STANDING: Thank you very much.

PC: Guy Standing is the founder of the Basic Income Earth Network and a Professor of Development Studies at the University of London School of Oriental and African Studies. We reached him in Geneva, Switzerland. Alright, coming up in our next half hour, what if instead of opting in to be an organ donor, it was automatic, with the only option being to opt out. That is the policy that's been implemented in France and it may be on its way to a province near you. We will debate presumed consent for organ donation, that is coming up. I’m Piya Chattopadhyay, you’re listening to the Friday edition of The Current. We're back in just a bit.

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Drafting policies to increase organ donations is complex but must be done, say experts

Guests: Michael Ravenhill, Dr. Sam Shemie, Jennifer A. Chandler, Linda Wright

PIYA CHATTOPADHYAY: Hi, I'm Piya Chattopadhyay and this is the Friday edition of The Current. Well, the new year means some big changes when it comes to organ donations in France. As of January 1st, the European country has strengthened its presumed consent policy. That means a person does not need to fill out a card or otherwise opt in to donate their organs after their death. Instead, everyone is presumed to be a donor. In France, the onus is on anyone who does not want to donate to opt out. And it's an idea that's been raised in Canada as well, most recently by Saskatchewan premier Brad Wall, who says he'd like to see his province move toward a presumed consent model. And that would be just fine by a Saskatchewan woman, 61-year-old Charlotte L'Oste-Brown, of Regina.

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I'm on the list for waiting for a double lung transplant because I have a disease called pulmonary fibrosis, which is shrinking of the lungs. And there is no medication for it. So I’ve had the disease now for 14 years, and I was able to get on the list about two years ago because my lungs have shrunk down so much now that I would need to get some new ones. Let's just say I'm running at about 35 per cent oxygen and I have a tank with me 24 hours a day. I'm on oxygen 24 hours a day. I mean, there's some days I can't even walk across the kitchen floor without getting tired. So yes, I am very much in favour of what Brad Wall has proposed. You know, I don't have any idea why something hasn't been done earlier. I just don't know. My biggest fear is that I'm not going to get my lungs, of course. I have to have the exact size that fit in my chest cavity. I have to have the exact blood type and I have to have the right antibodies. My theory is that I'm going to be a perfectly healthy woman that is going to die waiting for somebody to donate the gift of life.

PC: That's Charlotte L'Oste-Brown of Regina. Premier Brad Wall’s support for presumed consent has already been met with enthusiasm for others within the Canadian transplant community. Michael Ravenhill is the CEO of the David Foster Foundation, which offers financial support to children who need organ transplants and raises awareness about the need for organ donations. Michael Ravenhill’s based in Victoria but we've reached him today in Phoenix, Arizona. Hello.

MICHAEL RAVENHILL: Good morning.

PC: So you think premier Brad Wall's plan to bring in presumed consent for organ donations is a good one I assume?

MICHAEL RAVENHILL: Well, I think maybe a better question would be is does it bring up an opportunity to have a conversation about the opportunity to bring that type of program into place? You know, many people seem to, when you talk about organ donation and organ donor registration, the biggest concern that people have is the ability to have choice. And I think that's really where we, at the David Foster Foundation, we want to make sure people are educated well, they understand the importance of the need to become a registered organ donor and what that means to our society. What that means to people throughout Canada when we do something like this or if we were to do something like this or if it was implemented. It really comes down to the fact that when people feel government is maybe telling them to do something, they become maybe more offended, that people feel someone else is making a choice for themselves. That's when they get upset. And I think really when it comes to that, we say make sure that the choice is there. I can opt in, I can opt out. And as we see in other countries such as Wales, Belgium, Austria, Spain and now France, many countries are starting to go to this route.

PC: Well, let me ask you about that, because as you say, what people want, despite where they stand on this issue is choice. And really, the similar thing between Canada right now and the Frances and Austrias is that there is choice. So in our country you opt in, in those countries you opt out. What is the advantage, because they’re both choices. But what is the advantage of having that kind of law where you opt out?

MICHAEL RAVENHILL: And that's a great question. I think what it does is it provides the ability for more people to be registered organ donors. I’ll give you an example. In Canada, you know, we're one of the greatest countries in the world, developing countries in the world, yet we have one of the worst organ donor registration rates in the world. When you actually take an opt in system or an opt out system, the numbers for people that are in example, with what we do in Canada right now, you have to sign your organ donor card or you have to be registered on a registry. When you do that, the numbers right now, roughly 15, 16 per cent nationally. When you do something like Spain or Belgium or Austria with the opt out program, those numbers increase dramatically up into the 70s or 80s. So when you're looking at the opportunity to have a match like Charlotte Brown was talking about in Regina, that match opportunity becomes a lot greater for her. It shortens the long wait list that we have. We have over 4,600 people in Canada waiting for an organ right now, many will not make that wait.

PC: 4,600 people waiting. What's the average wait?

MICHAEL RAVENHILL: Well that, you know, that's--

PC: [interposing] Depends, I assume.

MICHAEL RAVENHILL: Yeah, it's very hard to determine what that is. It could be anywhere from a couple weeks to two years. And, you know, that's where we have, we see in our foundation, children that are on Berlin hearts, that are mechanical hearts keeping these children alive because they just can't find a match. Yet there could be a child that, you know, may be in another province or that has tragically died but they don't know about organ donation. They don't know about the gift of life and that really is what it is. We speak to many families that have gone through the tragic death of someone that have said this is the one thing that they hold onto in their darkest point of their life, to know that their loved one was able to give that gift of life to maybe improve the life of someone or save the life of someone, and they feel that that's the one piece that they can take with them to know that their loss has been a great gain for someone to continue their life.

PC: Michael Ravenhill, you know, listening to Charlotte's plea, if I can put it that way. And of course it's a dire situation for her as an individual. And I hear, you know, you say Canada’s 15 to 16 per cent, one of the lowest, and especially when you compare to countries like the Spains and the Frances and the Austrias, where we're 70 and 80 per cent. Why are we so low?

MICHAEL RAVENHILL: You know, that's a great question again. It really comes down to education. You know, there's such a misconception out there of what it is to be a registered organ donor, why it's important. You know, there's many times that people, you know, I’d speak to so many people that say well, if I'm a registered organ donor and I'm critically injured, will and they know that there's other people they could save three or four other people, will they let me die? I mean, these are just so far out in the field that it's just not possible. The medical system is so great in Canada and how it all works, there's just such a misinformation out there. We need to do a much better job like Austria and Belgium and Spain. Spain leads the way with an amazing education program. And they educate in the hospitals and in a way that they're training, they spend a tremendous amount of money with their medical teams and with the hospital staff, educating the general public on the importance of it and why there is a benefit to it to them and to their family members.

PC: Michael Ravenhill, thank you for your time today, I really appreciate it.

MICHAEL RAVENHILL: My pleasure.

PC: Michael Ravenhill is the CEO of the David Foster Foundation. We reached him today in Phoenix, Arizona. Well, presumed consent for organ donations is controversial among those who are immersed in the complexities of creating an organ donor system for Canada. Dr. Sam Shemie is a Medical Advisor for deceased organ donation at the Canadian Blood Services. He also works in the intensive care unit of the Montreal Children's Hospital, where he manages the care of patients who are about to become organ donors. We've reached him in Montreal. Linda Wright is an independent bioethicist and an Assistant Professor at the University of Toronto's Department of Surgery, where she's also a member of the Joint Centre for Bioethics. She's here in our Toronto studio. And Jennifer A. Chandler is a Law Professor at the University of Ottawa. As a recipient of the Bertram Loeb Research Chair, she has conducted a number of studies into various aspects of organ donation. She's in our Ottawa studio. Hello to all three of you.

MANY VOICES: Hello.

PC: Dr. Shemie, hello, let me begin with you. Where are you? What do you think of presumed consent for organ donations?

DR. SAM SHEMIE: Well, it's always a topic that generates a lot of attention and concern and support. And before I start, I just want to say that in our country every year there are almost 700 donors who have died, who have agreed to donate their organs and I'd like to express our deepest gratitude and honour those Canadians who have done that, and their families who have supported donation through a tragic loss of a loved one. We have learned a lot over many years on what makes an organ donation system work best. If today we went to a presumed consent system, it wouldn't solve the problem because there are fundamental challenges in the system and quite a lot of variability between provinces on implementing those things that we know improve organ donation. And so what we have said at Canadian Blood Services is presumed consent, interesting, maybe some time, but before you even talk about presumed consent, you have to have an organ donation system that works well. And an organ donation system that works well means you've got people in hospitals whose job it is to manage organ donation. These are donation focused nurse coordinators and donation focused physicians, whose job it is to make sure that organ donation is managed properly at the hospital level. You have to make sure the ICU community is doing all it can to perform all forms of donation. We can't be missing potential donors. Right now we know that we, depending on where somebody dies in the country, which province, which city, which hospital, which place in the hospital, that these potential donation opportunities are missed and families aren't even offered the possibility to donate. We have to educate our health care professionals and we have to measure what we're doing to make sure we're not missing donation.

PC: OK. There's a long list there and we're going to talk more about them. Linda Wright, well, as Dr. Shemie was speaking you were nodding your head quite vigorously. So what do you think of the idea of presumed consent, picking up on what he said?

LINDA WRIGHT: We certainly want to increase organ donation, there's no question about that. [clears throat] Excuse me. The question is evidence from around the world is not that this is the quick fix that's going to make everything better. And as Sam said, there are other things that we can do and in fact Ontario has already done. And we have an organ donation rate that reflects that. Ours is above the national average, it's very good.

PC: Very good meaning what? You know, the numbers--

LINDA WRIGHT: 26 per million population, which is equivalent to the United States, in fact surpasses that of the United States in some cases. So we have brought in things like having more trained professionals having identified a donation, doctors in the hospitals, as other places have done as well. Also, the availability of resources within the hospital of course is very important. And also, things like we're doing this morning, of enabling the public to know more about organ donation and how it works and trying to dispel some of those myths, I think, is going to help improve our rates.

PC: Jennifer Chandler, let me bring you in here. As we heard from our guest earlier Michael Ravenhill, you know, Spain is sort of held up to be the model, in the sense that it has presumed consent, it leads the world in organ donation. And Dr. Shemie and Linda Wright both say, you know, there's a lot of complexities to that. Why does it work so well in Spain? Do they have all their ducks in a row, so to speak?

JENNIFER A. CHANDLER: Well, I think there's a couple of reasons for Spain's success, and I think Sam and Linda can speak to this perhaps more than I can. But what I understand is that they have a system in which there's tremendous infrastructure to identify and promote opportunities for donation to capture every possible donor. I think also they follow forms of donation that are not established in many other countries. For example, people who have heart attacks outside the hospital can often go on to be donors, and this is not a form of donation population that is targeted in Canada and elsewhere generally. So I think that there's a variety of reasons, not just the larger potential population, because a greater number of types of donors are accepted, but also a very well organized, heavily promoted and well-funded infrastructure within the hospitals to make sure this works.

PC: Dr. Shemie, I want to talk about your frontline work, because there you are at the ICU at the children's hospital in Montreal. And you go in and you talk to children and their families, parents of these children, and you have these conversations about organ donation. And I appreciate that every conversation is different. But can you tell me what that's like?

DR. SAM SHEMIE: Well first of all, you know, I work in intensive care unit where our first and foremost priority is to try to save life. And certainly in pediatric intensive care units, the majority of time that's true. 98 per cent of people who come to an ICU survive in pediatrics, less so in adults. And so when we deploy and use all these interventions and treatments to try to save life, we do that with all our efforts. But there are situations where despite all our efforts, the illness or the injury that that child and that family faces is overwhelming and cannot be reversed, and then we recognize that that patient is going to die. And the first thing that families need to accept is that huge understanding that despite everything that that child is going to die. And that's really the first challenge of walking families through that difficult process of understanding that there's no other helpful treatments that can reverse what's going on except the fact that somebody is going to die. And then in a sensitive, compassionate and factually accurate way, provide information for families to make a choice on behalf of their loved one. It helps if that person who's dying has indicated a wish to donate. Either by telling their family, by signing a donor card, by registering on an online registry, that helps the situation in that we want to make sure that if a person wanted to become a donor, we do everything to make sure that happens. It's never an easy time. The discussions are occurring at the worst time in families lives, but it is always impressive to me how many Canadians agree to donate because they understand what it's like to lose a loved one, as they're doing, going through the loss of a loved one within the intensive care unit and they know that organ donation can save many lives and prevent the loss of life in other Canadians.

PC: I'm glad you brought up this idea of consent. Because Linda Wright, you've been looking into how families, this is a stressful time for everyone, you know, when someone is dying. But how families cope with decisions of organ donation, specifically when a family vetoes the wishes of the donor. So what did you find? Does it happen often?

LINDA WRIGHT: [clears throat] Excuse me. It happens certainly more often than we would like, because we're trying to balance at that moment honouring the autonomy of the person who has died with the psychological comfort that we're offering to the families. And we certainly don't want to do anything to increase their discomfort. Sometimes families don't know that the person had signed their donor card, wanted to be a donor. So it can be new news to them at a time when they are emotionally very distressed. So we do encourage people to tell their families what their wishes are for donation.

PC: Why else do families oppose?

LINDA WRIGHT: [crosstalk] They may disagree. They may feel that it's not what they would want for themselves. Sometimes the donation process can take more time than what they would like to spend at the hospital, having already been there for a while and they want to move on and say their goodbyes and move on. So I think there are a number of elements that combine that to affect that.

PC: And what happens when there is disagreement? Is there a legal obligation for the staff to go proceed with the organ donation if a family member doesn't consent?

LINDA WRIGHT: Jennifer can speak more to the law, she’s the law professor.

PC: Will Jennifer speak to it then? I mean, what happens?

LINDA WRIGHT: [chuckles]

JENNIFER A. CHANDLER: Sure sure sure. Well, the law says that if someone has registered, that constitutes binding consent and that's sufficient for doctors to go ahead with the donation. But in practice, doctors will consult with the family for a couple of reasons. One is they want to know if in fact the person ultimately changed their mind despite being registered. Also, they need to talk to the family to get medical information about any potential health risks. So in practice, actually both in our system but also in presumed consent systems where there's opt out, doctors will talk to the families. And now, families are not entitled to invalidate the consent, it's a binding consent, it still stands. But just because somebody consents, doesn't mean someone has to take an organ. So the doctors retain discretion to decide, OK, what are we going to do in this situation? Can we convince the family? Can we bring this along? But ultimately if not, my understanding is that many doctors will decide that rather than creating additional trauma to the family, they will regretfully not proceed with the donation.

PC: And Jennifer, if we were to adopt a presumed consent model, I mean, those ethical issues that you just raised don't go away. But are there, I guess, new ones that you would identify, if we went the other way and did a presumed consent model?

JENNIFER A. CHANDLER: Well, I guess one thing I would suggest, which is interesting about the recent French change is they've had presumed consent for a while, but they were going and asking families, and some families were coming up with a whole range of reasons, like some of the ones that Linda just mentioned not to donate. And so the change that came into effect January 1, was they now require families who are trying to stop the donation of someone who is presumed to consent to actually prepare a signed written document providing specific information about how the person actually did not want to donate, despite not having opted out. And so this is a strengthening of the system, because it makes it a little bit harder for families to come up with other reasons, they have to do a signed written document. And this has been a bit controversial in France, with people saying oh, this looks like we don't believe what families are saying. But this is something that can be put in place with a presumed consent system that would perhaps, you know, help to make it a little stronger and also reduce the incidence of families actually, you know, opting the person out even with a presumed consent system.

PC: Dr. Shemie, you know, we've all mentioned, you know, who's doing well and who's not doing well. Sort of, you know, Ontario. British Columbia, Nova Scotia and Quebec do relatively well as provinces within our country for organ donation. But as an entirety, our country lags behind others. Not just the Spains but Malta and Croatia for example. I guess what I wonder is why do we do so bad? So Dr. Shemie, like, why do we do so bad? What do we need to do to make it better if we don't change our system to a presumed consent one?

DR. SAM SHEMIE: So first of all, if you speak to Spain, which is the recognized international leader and ask them what they think their most important impact of their donation system, they'll say presumed consent was the least important. The most important are things that we've talked about, investing in donation focused personnel, nurses and doctors who are responsible for it, implementing best practices in intensive care units, having the system required to refer all potential donors and offer that to families, professional education and measuring what we're doing. It's interesting, because the highest donor rate in the world right now is in Philadelphia, Philadelphia Gift of Life. And their donor rate exceeds Spain. And they have an opt in system, the same as we have here in Canada. And the reason they're doing so well is because they've implemented all those foundational components of the donation system, such that if you do that, it makes the need for presumed consent much less. If we look at British Columbia, Ontario, Nova Scotia and Quebec, they all have similar characteristics, in that they've begun and furthered the implementation of these best practices. In the provinces that are doing not so well, it's because they haven't done those things. And so what we're trying to do at Canadian Blood Services is coordinate everybody to implement those best practices and features of the donation system that we know leads to improving donation rates and increasing the availability for organ transplants for Canadians in need.

PC: Linda Wright, you work here in the Ontario system, you look at it. And pick up from what Dr. Shemie said, Ontario is doing things well.

LINDA WRIGHT: Yes, as are some other parts of Canada too.

PC: Yeah.

LINDA WRIGHT: But exactly as Sam says. The Spanish will tell you that you don't need to have opt out, I prefer to call it opt out, I don't like to presume any one's consent, In order to have good donation rates. And their rates had increased before they brought in their opt out system. So we need to do more of all of those things. And it requires resources, it requires a determined effort to put our backs to this and to invest in those people and resources that work in this field and can do this better. We're doing well but we need to do much better.

PC: I know there are 100 barriers, more than 100 barriers to even make it a suggestion that some might make. But is it time for a national registry?

LINDA WRIGHT: Well, we have registries in some provinces and perhaps it would be easier if we had one national registry, that would help. Certainly it would be lovely to have registries in every province of Canada because that enables people to say this is what I want to do, which helps families make those decisions when they're asked do you want to to agree to this donation or not? So I think yes.

PC: Jennifer Chandler, the one thing that you think would have the most impact on increasing the level of organ donations in our country?

JENNIFER A. CHANDLER: I think it would be the one mentioned by Sam already, which is to have a greater investment in the infrastructure in the hospitals to identify and support organ donation.

PC: Thank you to all three of you. Appreciate all your time today. Dr. Sam Shemie is a Medical Advisor for deceased organ donation at Canadian Blood Services. He was in Montreal. Linda Wright is an independent bioethicist and an Assistant Professor at the University of Toronto's Department of Surgery, where she is also a member of the Joint Centre for Bioethics. And Jennifer Chandler is a Law Professor at the University of Ottawa, where she holds the Bertram Loeb Research Chair. She was in Ottawa. We do want to hear from you on this and any other story you hear here on The Current. So you can get in touch with us. You can tweet us @TheCurrentCBC, you can tweet at me as well, my personal handle is @Piya, P-I-Y-A. On Facebook search on facebook.com, search for CBC The Current. Or you can e-mail us by going to our website, which is cbc.ca/thecurrent. And once you're there, click on the Contact Us link. Alright, that is The Current for today. And before we sign off today, we have some time, we've got to say some thank yous.

[Music: Credits Theme]

VOICE 1: And now it's time to give credit where credit is due. I’m Pacinte Mattar, one of the producers here at The Current. The rest of my colleagues that helped put the show together this week are Idella Sturino, Howard Goldenthal, Ines Calabrese, Sujata Berry, Liz Hoath, Sarah Grant, Samira Mohyeddin, Karin Marley, Kristin Nelson, John Chipman, and Willow Smith.

VOICE 2: Special thanks this week to network producer Michael O’Halloran in Calgary, Suzanne Dufresne in Winnipeg, Anne Penman in Vancouver and Jack Julian in Halifax. The Current’s writer is Peter Mitton, our web producers this week were Lisa Ayuso and Sarah Claydon. Transcriptions are provided by Eunice Kim and Rignam Wangkhang. Our technical producer is Gary Francis and our documentary editor is me, Josh Bloch.

VOICE 1: Our senior producers are Cathy Simon in Vancouver and Richard Goddard in Toronto, with Shannon Higgins filling in this week.

VOICE 2: The host of The Current is Anna Maria Tremonti.

VOICE 1: The executive producer of The Current is Kathleen Goldhar with Lara O'Brien filling in this week.

PC: And remember, you can always take The Current with you on the go on the CBC Radio app. It is free from the App Store or from Google Play. I'm Piya Chattopadhyay, I want to just tell you if you're interested in listening to my show Out in the Open, which has been airing on Saturdays, we're movin times, we're going to Sunday, Sundays at 11:00, starting this Sunday, right after The Sunday Edition with Michael Enright. So I hope you'll also tune in for that. I am Piya Chattopadhyay, thanks you very much for lending us your ear here on the Friday edition of The Current.

[Music: Extro]

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January 6, 2017 full episode transcript

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