If you live in Alberta, you’ll likely soon be an organ donor.
On Wednesday, the legislature there passed the first reading of the Human Tissue and Organ Donation (Presumed Consent) Amendment Act Wednesday, aka Bill 205. The bill moves the province towards “opt-out” organ donation, where everyone is assumed to be an organ donor, unless otherwise stated.
“If at the time of a person’s death no decision has been made,” Bill 205 reads. “The person is considered to have, before their death, made the decision to donate their organs and tissues for the purpose of transplantation only.”
The mandatory donation will not apply to minors under the age of 18, and people who have not lived in the province for more than 12 months.
This makes Alberta the second province in Canada to move towards an opt-out system, following Nova Scotia. Countries around the world have moved to similar systems, including Spain and Belgium.
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Organ donation in Nunavut and the Northwest Territories is currently coordinated by Alberta Health Services. Prospective donors are directed to register through Alberta’s existing donor registry, though the territories are not named in the first reading of Bill 205. It is unclear if they will also move to an opt-out system.
Proponents of the Alberta bill hope it will lead to an overall increase in the availability of donor organs in the province. According to Alberta Health Services, there are over 700 Albertans currently on transplant waitlists.
But where do the other provinces and territories stand?
Nova Scotia actually beat Alberta to a policy of presumed consent for organ donation. The province tabled legislation in April that would make it the first jurisdiction in North America to have opt-out organ donation. It is set to come into effect in mid to late 2020.
The new legislation will require all potential donors to be automatically referred to programs to determine if they are good candidates. Details on how people can opt out of donation will be made available in the coming months.
Ontario currently has an opt-in system similar to the existing one in Alberta. Ontario residents must register their consent to donate, even if they signed a donor card, to ensure the information is recorded with the government. Anyone over the age of 16 with a valid health card can register.
In B.C., you must register to be an organ donor. You need your personal health card number, and must be over the age of 19 or have a parent or guardian sign on your behalf. The province also has a public registry where you can check if you’re registered, or loved ones can verify if a recently deceased person wished to have their organs donated.
Earlier this year, the Saskatchewan government announced an organ donor registry that will launch in early 2020. This publicly available registry will allow loved ones to know if a recently deceased person wished to have their organs donated.
“In Canada right now, legally, families still have the option to opt-out even if it was their loved ones’ wishes to donate. I’m told that registries that are in operation that in those cases 90 per cent of families accept what the wishes were. Those without registries is less than 50 per cent,” Saskatchewan Health Minister Jim Reiter said at the time.
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While the province, like most of Canada, currently has an opt-in system, Reiter has not ruled out following Alberta’s lead and moving to an opt-out one. Until the registry is available, Saskatchewan residents can add an Organ and Tissue Donor sticker to their Saskatchewan Health Services card and sign the Intention to Donate card.
Manitoba has an organ donor registry. Anyone 18 years of age or older can register online with their health card and date of birth.
In Quebec, you can consent to organ donation in three different ways. You can register with the Régie de l’assurance maladie du Québec (RAMQ) organ donor registry, sign a sticker and affix it to the back of your health insurance card or register with the organ donor registry established by the Chambre des notaires du Québec.
Anyone over the age of 14 can register to donate. Anyone under 14 can also be registered with a parent or guardian’s permission.
Like most provinces, New Brunswick has an opt-in system. Residents can indicate their intent to donate by checking the appropriate box on a medicare change request/replacement /renewal form, and parents or guardians can give consent for minors. Under the province’s Human Gift Act, family and next of kin can consent for a deceased person to be an organ donor if their wishes were not recorded.
Prince Edward Island
In P.E.I., anyone over the age of 16 can consent to be an organ donor. Unlike many other provinces, parents cannot provide prior consent for children under 16. Parents can only consent on behalf of their children when the opportunity to donate arises.
People who want to register to donate can fill out this form.
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Under the Yukon’s Human Tissue Gift Act, residents can choose to donate any organ or tissues needed for transplant or transplant research; any organs and tissues needed for transplant only or any organs or tissues needed for transplant with some exceptions.
People who fill out an organ donation form will get a specialized sticker for their health card, showing their designation as a donor. A parent or guardian must sign if the prospective donor is under 19.
Newfoundland and Labrador
Organ donation in the easternmost province is also done on an opt-in basis. Prospective donors can indicate their “intent to donate” when renewing their health care plan. The form must be signed by a parent or guardian if the prospective donor is under 16.