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New Nova Scotia organ donation bill emphasizes presumed consent

Premier Stephen McNeil speaks to organ recipient Cindy Ryan at Province House on Tuesday after he announced changes to organ and tissue legislation. Ryan has received two liver transplants since 2013 after she contracted a virus that attacked her liver. - Eric Wynne
Premier Stephen McNeil speaks to organ recipient Cindy Ryan at Province House on Tuesday after he announced changes to organ and tissue legislation. The Westville woman has received two liver transplants since 2013 after she contracted a virus that attacked her liver. - Eric Wynne

Everyone will be a presumed organ and tissue donor under provincial legislation tabled Tuesday.

Currently Nova Scotians must indicate whether they want to be a donor when receiving or renewing their MSI health card. Under the new legislation, an individual will have to opt out of donations, which would be a first in North America. 

“This is about doing our best for Nova Scotians waiting for life-saving transplants,” Premier Stephen McNeil said in a news release. “We know there is support for organ and tissue donation in our province and this legislation is another step in ensuring there are more potential donors who could save lives and make a lasting difference.”

The Liberals say the presumed donor change will give patients waiting for a transplant a better chance of getting one sooner, no matter where they live in Nova Scotia, by increasing available organs and tissues.

McNeil introduced the bill, called the Human Organ and Tissue Donation Act, in the House on Tuesday. But it won’t be proclaimed for 12 to 18 months while the government conducts a public education campaign on its details and ensures that supports for clinical teams around the province, particularly in rural areas, are put in place. 

The rules around donating organs and tissues have been in limbo in the eight years since the then-NDP government tabled a bill of the same name that was never proclaimed. That 2010 legislation will be repealed and replaced by the Liberal version. 

Health Minister Randy Delorey attributed the delay to the work involved in updating the technical wording of the legislation around presumed consent and giving family members the chance to give input into the organ donation decision.

“In this legislation the decision where the wishes are unknown, that’s where the presumed portion comes into play,” Delorey told reporters. “But clinicians would still have the conversation with loved ones to try to ascertain and have the conversation (about) the donation. . . .

“If in that context they are able to illustrate that the patient, the individual’s wishes had changed in between, that could update the wishes as a substitute decision-maker or loved one at that point in time.”

Delorey urged people to have regular conversations with their family about their wishes. 

In 2018, 21 Nova Scotians became organ donors and 110 donated tissues like corneas and heart valves. There are 110 Nova Scotians waiting for organ transplants.

Organ recipient Cindy Ryan of Westville, Pictou County, who spoke at the government’s news conference, welcomed the move toward presumed consent. 

After a virus attacked her liver, Ryan went into a coma and her family was told that without a liver transplant, she would only have four weeks to live. After complications with her first transplant in 2013, she required a second one in 2015.

“I literally would not be here if it wasn’t for organ donation and organ donors,” Ryan told reporters after the announcement. “It’s important to me because I’m hoping that it increases the number of donors in our province and increases organ and tissue donation awareness. . . . 

“I think because we have to tick the box to say yes, I think sometimes people don’t know or they’re in a rush when they’re filling it out and they don’t bother. So I think if it’s an opt-out, hopefully there will be more people that are going to be donors. “

"Organ and tissue donation is a medical miracle and can give comfort to families who see something positive from a loved one's death," said Dr. Stephen Beed, medical director of the Nova Scotia Health Authority's organ and tissue donation program Legacy of Life, in the release. "This legislation will help more patients get the good news they've been waiting for."

Those under 19 and those without decision-making capacity will be exempt from the presumed consent program, and will only be considered donors if a parent, guardian or substitute decision-maker opts them in.

For more information about the legislation, visit novascotia.ca/organdonation.

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