opt out organ donation
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Health In Mind (a non profit association) proposes an opt-out organ donation system for Canadians.
Canadians are paying the ultimate price for the shortfall of organ donations; we are donating less than the USA and many other countries (Government of Canada, 2017). In 2014, 278 people died waiting for a transplant and over 4500 Canadians were waiting for transplants (Government of Canada, 2017). In 2015, there were again more than 4500 Canadians awaiting a transplant (i.e. rates have not improved) (Canadian Institute for Health Information, 2015). Systematic review have shown that opt-out organ donor systems increased organ donation rates by 25-30% (Rithalia, McDaid, Suekarran, Myers, & Sowden, 2009).
Compared to the current opt-in donor system in Canada, we believe that the proposed legislation of an opt-out donor system better meets the four basic medical principles of healthcare (beneficence, non-maleficence, justice, and autonomy) (Canadian Medical Association, 2004). Canadians would likely require fewer live donors; better allocate money spent on dialysis to other health-care needs; bypass committing organ trafficking overseas; evade the negative consequences of having organs transplanted overseas; reduced wait times for organs; reduced deaths due to lack of donors; and makes a scarce resource, organs, more available.
The organ in highest demand in Canada is for kidneys (Government of Canada, 2017). In fact, 77% of Canadians waiting for transplants are waiting for kidneys (Government of Canada, 2017). Some Canadians are willing to partake in organ trafficking and or obtain organs through ‘transplant tourism’ (acquiring a new organ overseas) (Kapoor, Kwan & Whelan, 2011; Quach et al., 2016). Furthermore, studies have found that Canadians partaking in ‘transplant tourism’ have outcomes worse than patients getting transplants in Canada, legally (Kapoor, Kwan & Whelan, 2011; Quach et al., 2016). Systematic analyses concluded that ‘transplant tourism’, increases the risks of acquiring viral infections (e.g. cytomegalovirus, hepatitis B, HIV), diabetes mellitus, and or other complications (Anker & Feeley, 2012).
While we do not condone Canadians to partake in overseas organ trafficking, we understand that many Canadians feel that they have no other choice. In fact, many physicians report that these patients have no regrets despite medical complications -- likely due to the life and death circumstance that they are faced with (Blackwell, 2016). Should we not do as much as we can to improve rates of organ donors to relax the pressure on living citizens to donate or for patients to consider organ trafficking?
Of course, we understand that legislating an opt-out system will not be a cure all for the lack of organs currently required. We can take heed from countries such as Spain. Spain saw increases in organ donation once an opt-out system was legislated, as well as changing their organ transplant system to a nationally governed one (Willis & Quigley, 2013). Of course, other factors such as the amount spent on health care, religion, mortality from motor vehicle accidents, public discourse, and the role that families may play all factor in as well (Willis & Quigley, 2013).
Lastly, The Canadian Transplant Society (2014) found that 90% of Canadians supported organ donation. We believe that legislating an opt-out organ donation system is the first step in creating a safer, less costly, smarter way to extend the lives of Canadians. There will be other steps along the way that will be required to increase rates of Canadians that receive the transplants that they need both safely and legally -- let this be the first big step towards that.
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