Liberal bill on organ donation would create system of presumed consent

The New Brunswick Liberals introduced proposed legislative amendments Tuesday that would see the province follow the lead of Nova Scotia and switch to a program of "deemed consent" to organ and tissue donation.

Right now, New Brunswickers may give their consent for organ and tissue donation when they apply for or renew their medicare card, by checking the appropriate box.

The idea behind the Act to Amend the Human Tissue Gift Act is that every New Brunswicker aged 19 and over, who is not exempt, would be considered for organ and tissue donation, unless they opt out.

"Today, there are over 140 New Brunswickers waiting for transplants," said Opposition Liberal health critic Jean-Claude D'Amours, who introduced the proposed legislation, also known as Avery's Law, in honour of Avery Astle, 16, who died after a crash in Miramichi in May 2019.

Avery's parents wanted to donate his organs and tissues, including his blue eyes, but were told no one from the specialized donation team, which is run by Horizon Health Network, was available to retrieve his organs.

"The stress [people waiting for transplants] and their families go through waiting to receive word of a positive match is extraordinary," said D'Amours. "Anything governments can do to improve tissue and organ donation will be received with great relief and renewed hope.

"For all of these New Brunswickers, as represented by Avery Astle and his family, we urge the Higgs government to move forward with our amendments."

Health Minister Dorothy Shephard did not respond to a request for comment.

Survey finds 79% 'likely to support' switch

Dr. Jeff Steeves, president of the New Brunswick Medical Society, and Kurtis Sisk, chief executive officer of the Heart & Stroke Foundation of New Brunswick, issued a joint statement, applauding the amendments and urging all political parties to support the switch.

"We need to reduce barriers to organ and tissue donation," it said. "Simply put, organ and tissue donations save lives."

Seventy-nine per cent of residents surveyed by Narrative Research indicated "they are likely to support presumed consent organ donation law," according to the joint statement by the groups that have advocated for the change. The total number of residents surveyed was not provided.

"According to the New Brunswick Organ and Tissue Program, approximately 347,000 New Brunswickers (46 per cent) have indicated they wish to be a donor. Another 279,000 (36 per cent) prefer not to donate, leaving 140,000 (18 per cent) as unknown. We can do better."

'Well worth considering'

In April 2020, then-health minister Ted Flemming told CBC News presumed consent for organ and tissue donation was "well worth considering."

He had asked Department of Health officials to get a copy of Nova Scotia's bill and "examine its potential" for New Brunswick, he said. No findings have been released.

The Liberals propose a registry be established to record consents or refusals under the act.

New Brunswickers would register a decision to consent to donate all or some of their organs and tissues — what's known as express consent — or opt out of donation.

Those who do not register a decision will still be considered a potential donor, with a few exceptions. Under the proposed legislation, their decision will be deemed to have been given, so-called deemed consent.

"Research indicates that moving to deemed consent in New Brunswick has the potential to improve the lives of 80 more New Brunswickers who are waiting for organ and tissue donations annually," said D'Amours.

Liberal Leader Roger Melanson said it's "just the right thing to do."

His party plans to have conversations with the MLAs from all parties in the coming days to gauge their support, he told reporters.

"If there's a willingness, we can do this quicker, than later," he said. "This would be a piece of legislation we'd like to see adopted and get royal assent before we break by the end of June."

D'Amours said he's encouraged by the success of the implementation of deemed consent in Nova Scotia.

Nova Scotia became the first place in North America to switch to an opt-out organ and tissue donation law on Jan. 18. The law exempts children, people who lack decision-making capacity, and adults who have lived in the province for less than a year. Families will still have a final say at the bedside.

Nova Scotia was prepared to see the five to seven per cent of the population opt out, based on the experience of Wales in 2015. But the head of the program is cautiously optimistic the new presumed consent law is being embraced after only about one per cent of the population chose to opt out 10 days after the law was implemented.

A total of 250 Canadians died while waiting for a transplant in 2019, according to the most recent figures compiled by Canadian Blood Services, the Liberals said in a news release. That's an increase from 223 in 2018.

Another 4,419 Canadians were still waiting for transplants at the end of 2019, the figures show.

The World Health Organization reports that in jurisdictions with opt-out laws and where consent is presumed, donation rates are 25 to 30 per cent higher than in those countries requiring explicit consent.

Wales, Spain, Croatia, Chile, France and Portugal are among many nations that have presumed consent systems.