Friday, February 24, 2006

Another Organ Donation System Proposed for Ontario

Following Ontario's New Democrat MPP Peter Kormos' introduction of a private member's bill last week calling for presumed consent for organ donations unless the potential donor has "opted out" by previously signing a document to that effect, Conservative Frank Klees proposed a bill February 22nd that would deny driver's licenses and health cards to people 16 and older unless they signed a donor card indicating yes or no to organ donation.

So the debate on organ and tissue donation continues. My position has not changed. I believe we should give Ontario's new system, implemented by Trillium Gift of Life Network (TGLN) this past January, a chance to show that it will dramatically increase the rate of donation in our province from the present almost 13 per million population to hopefully near the rate of 33.1 per million enjoyed by the Philadelphia area. Ontario's new program is very similar to the successful Philadelphia system.

Ontario's new system is called Routine Notification and Request (RNR) and is designed to maximize organ and tissue donation. It is a provision of the TGLN Act passed in 2000, with the implementation of the RNR program this year.

Under RNR guidelines, designated facilities report to TGLN when a patient has died or death is expected by reason of disease or illness. Once eligibility has been determined, the hospital then approaches the patient or the patients' family to discuss donation options.

Do you have an opinion on this? Leave a comment below.


Anonymous said...

Hi Merv,

I do appreciate your facutal and unbiased info updates.

Your opinion is valued because you are knowledgeable and sensible too:)

We in New Brunswick now have similar legislation requiring that the family of all potential donors must be approached at the appropriate time. Hospitals have trained staff on duty at all times so the request is handled well and the retrieval is co-ordinated.

Our endless challenge is the education of our citizens. Many still seem oblivious to the need to discuss the topic of organ and tissue donation. The steps are simple - discuss, make a decision and tell your family your wishes.

At minimum, these proposed legislations will raise the profile of organ transplantation with increased media attention and discussion.

I do wonder if there's merit in forcing the conversation by "withholding" a driver's license until the candidate checks "yes" or "no". Then again, at what point is the family discussion held - before or after the signing .... or never?

We are striving to improve this communication by unifying the message (there are currently many pamplets and brochures is circulation) and co-ordinating a personal delivery system (speaker's bureau).

Advice or opinions would be appreciated.

One question - How long will it take to notice an increase in the availability of organs?

Anonymous said...

The death or imminent death of a family member is a very difficult time to be asking for an organ donation. London Health Sciences Centre followed similar procedures for years when I worked there & our donation rate was no better than the rest of Ontario's. I have seen staff assaulted both verbally & physically. Under these circumstances, would you like to put yourself at risk?

Anonymous said...

Your dedication to transplant fundraising and education is well known, so please don't take my comments personally.

Trillium's past initiatives to increase donor rates have been unsuccessful in that donor rates have not increased in Ontario. That track record alone makes me question Trillium's ability to fulfill the mandate it was given when it was set up under Mike Harris' government five years ago: to increase donor rates significantly by 2005.

Trillium has had five years! What has it done? What happened with the initiative to place donor teams in emergency rooms? And ask the media about cooperation from Trillium to provide information and/or work with them on stories that would increase awareness. You can't have an organization dedicated to increasing donor awareness that doesn't know how to court relationships with the media.

I have a tragic story that illustrates my point. A fellow double lung transplant recipient's triumph made a huge impression on her family. They all signed their donor cards, including her cousin. Her cousin died suddenly from an aneurism in her brain, but her mother was so distraught she didn't remember her daughter's wishes until it was too late. She had a signed donor card, but it proved useless.

The current system is not working. The new initiative doesn't seem all that different from what Trillium was supposed to have been doing all along: increase organ donation by direct contact with potential donor families.

I believe that both the NDP and Conservative proposals is a positive step in the right direction: at the very least because it opens up discussion and debate on the issue. At the most, because it's offering options to the current system. Ultimately, we all want the same thing: to increase organ donation.

Presumed consent works well in other countries. And it's not about the government having control over our bodies (as some fear-mongers have suggested). If people don't want to be organ donors, they sign to that effect and their bodies won't be touched.

Organ donation is not a sci-fi movie where doctors troll the emergency rooms looking for potential donors. Education is sorely needed and needs to be emphasized in this area. For someone to meet the criteria for brain death, seven different tests are performed two times each by two doctors NOT associated with transplant. There is no margin for error.

In any case, something has to change to avoid people like my friend's cousin being denied the right to be an organ donor even though she had signed a card expressing her desire to be an organ donor. In that case, her rights were violated.

Efforts in education need to continue and become stronger. Bravo to all those who are out there talking to communities about organ donation. Keep up the good work!

As I said, Merv, my opinion is not about criticizing the efforts of those who are out there making a difference. It's about questioning the effectiveness of Trillium's initiatives within the hospital environment.