Opt-Out Organ Donation & Presumed Consent

This week, the Province of Nova Scotia announced that they will become the first jurisdiction in North America to have presumed consent for organ and tissue donation. What does this mean? Essentially, exactly what it says.

Instead of waiting for people to ‘sign up’ as donors, their consent would be presumed, except in the cases where Nova Scotians make the choice to opt-out (or other situations where the person lacks the capacity to understand).

Whatever their reasons may be, that choice to opt-out is important, and understanding that is key to understanding this policy as a whole. This is not about taking away an individual’s autonomy over their own body, because that ‘opt-out’ option unequivocally ensures it. This policy does not eliminate your right to make choices over your own body, because again – that ‘opt-out’ option ensures it.

Instead, this policy would facilitate and streamline the organ donation process in a more patient-centred way, and ultimately the goal would be to save lives.

And while yes – people may have their reasons for opting-out (and that’s their right), I can’t imagine a world in which the vast majority of the population would be opposed to saving lives.

It’s important to recognize that organ donation isn’t as simple as harvesting the organs from any patient who dies, regardless of circumstance. In fact, in the linked article above  it’s noted that last year, there were just 21 organ donors in Nova Scotia. That’s very low, given the number of Canadians awaiting transplant right now.

It’s a rare and typically tragic circumstance when a person actually can be an organ donor. When my mom died, she experienced a fatal “brain bleed” leaving her “brain dead,” so that while she was able to be kept alive on machines, her actual state was incompatible with life. This was confirmed by multiple doctors after multiple tests, to the point that there was absolutely zero question or margin of error. It was agonizing. But, because of her very specific medical circumstance, it was also an instance that became a miracle for others. It’s also important to note that when these instances occur, the family or next-of-kin of the patient ultimately does get the final say. From everything I’ve read, I understand that will not change under presumed consent.

I understand that there has been a level of backlash throughout the Province since this announcement was made. I’ve read the comments sections and have done my best to understand the fury felt by those who feel this is a violation of their rights.

Here’s the thing though – I am a huge advocate for bodily autonomy. That applies to every aspect of life. I believe in asking before hugging someone you’ve just met. I believe in a woman’s right to choice over her own reproductive system. And of course, I believe in the incomparable importance of not just consent – but enthusiastic consent when it comes to sexual relations.

However, I think when people compare this policy to the #MeToo movement and suggest it’s the same thing, then we are blurring lines that have no need of being blurred.

Sexual assault causes pain and trauma.

Organ donation saves lives.

A sexual assault survivor will live with the after-effects of their experience for the rest of their life.

An organ donor (with the exception of living donors, but obviously that doesn’t apply here) will not live, because this is a gift they give in their death.

The families of the donor will absolutely live with the memories of the organ donation process, and I know first hand that it can be traumatic and trying.  I’ve been there.

However, that incredible pain is a small price to pay when you’re already facing massive loss. Because with the price of extending the process, you’re also able to give an incredible gift.

It’s about the opportunity for a second chance at life for another Canadian. And while your family will be undoubtedly grieving, another will be rejoicing.

It’s cyclical in the most beautiful way, and though it’s undeniably painful, it’s also undeniably incredible.

While I agree that it would be nice if we could rely on people signing their donor card on their own terms, the reality is that like many things in life, it’s one of those ‘chores’ we feel like ‘we really should get around to at some point.’ And in our busy lives, far too often, we never do.

Presuming consent doesn’t take away your right to choose. It just makes your right to choose ‘yes’ a heck of a lot easier. And if you want to choose ‘no,’ you can do so at your own freewill. Whatever your reasons, that is your right. That provides you with autonomy over your own body, even in your death.

I know not everyone sees it this way, and that’s fine. However, this is the perspective I wholeheartedly believe in, as the daughter of a donor who has made that choice based on the presumption it’s what my Mom would have wanted.

I know how difficult it is for donor families and I would never wish that upon anyone. However, for anyone who’s experienced a tragic loss like we did, I would pray they’d find healing and hope in something the way we have in organ donation.

I believe in doing the right thing, whenever we can. I believe that a policy like this makes the decision to do so a whole lot easier for families who are experiencing the very worst day of their live.


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