'Presumed consent' option for organ donations sparks debate

Ontario hospitals should be able to freely harvest organs unless a dying patient objects beforehand, says a private members bill introduced in the provincial legislature on Thursday.

New Democrat MPP Peter Kormos, who drafted the bill, said its aim is to reduce the number of people who die awaiting transplants.

Peter Kormos

• INDEPTH: Organ donations

"Most people want their organs to be used," said Kormos. "But strangely, those same people don't sign organ donor cards."

Last year, there were 142 organ donations in Ontario, and hundreds of people are on waiting lists. In 2004, nearly 250 people across Canada died while waiting for a transplant.

In Canada, about 14 in every one million people donate their organs after they die. Portugal, Spain, and the United States have donor rates ranging from 20 to 32 per million

The practice of "presumed consent" is already practised in Spain and Italy, but the idea is receiving mixed reviews in Ontario.

If passed, the law would not oblige someone to donate.

But a presumed consent system can cause extra trauma for family members who are grieving, said Trudo Lemmons, a medical ethicist at the University of Toronto. A system of harvesting organs has to take into account their concerns, he said.

Opponents of the idea say there are other ways of increasing donations, such as a proposed law requiring people to declare their wishes when they renew their driver's licence.

Frank Klees

"The declaration allows for a yes, a no, or an undecided," said Frank Klees, a Tory MPP who is proposing the alternative approach.

A hospital staff's approach to a patient's family can also make a difference. Last month, Ontario adopted a new system to ask permission soon after death. Donations have doubled since then.

"This is a very difficult decision for people," said Frank Markel of the Trillium Gift of Life Network, the provincial body that administers organ donations in Ontario. "They have to think about this at a moment of tragic loss. It is very important that the idea be presented to them in the best light."