Quebec is within its rights to opt out of the newly announced plan to reorganize Canada's organ-donation system. Health falls under provincial jurisdiction, and if the provincial government wants to put jurisdiction before other considerations, legally it's on solid ground.
But jurisdiction should not be the guiding principle when it comes to patient care. What's best for the patient should be. Quebec should therefore provide very compelling reasons for opting out of an honest attempt to build a cohesive, collaborative pan-Canadian organization for organ donation and transplantation.
No such explanation is in sight - beyond saying that since it runs its own blood supply, it should handle organ donations and transplants the same way, alone. But Héma Québec, the blood agency, was Quebec's response to the tainted blood scandal, a set of unique circumstances that don't apply to the question of a transplant agency.
Defenders of Quebec exceptionalism argue that because the real problem is a chronic shortage of donated organs, reorganizing a dysfunctional system isn't going to work.
But one of Canada's foremost transplant surgeons, Phil Halloran, has long argued that centralizing Canada's fragmented system will improve the system's ability to deliver. In a TV interview last year Halloran, who is also editor of the American Journal of Transplantation, criticized the fact that Canada's organ transplant system is organized by province. Halloran said as many as 1,200 Canadians a year were dying because they could not get the life-saving organs they needed.
"It's quite a balkanized system and some parts of it in some regions are probably not functioning the way they should be functioning," he added, calling for a central body to promote organ donations, establish standards, collect data and distribute organs.
Quebec ought to be part of this effort. There is a great deal of room for improvement across the country, including in Quebec. By year's end 2007, there were 4,195 Canadians waiting for organ transplants. (More than 1,000 Quebecers were waiting in 2006, even though our current donor rate - 17.9 per million for deceased donations - compares favourably with the Canadian average of 13.5.)
Nothing Quebec says it can do on its own - co-ordinate with other provinces, prioritize its waiting list, encourage people to sign donation cards - couldn't be done better as part of a larger organization.
We want to believe that politics is not playing a role here, but in the absence of any compelling reason to pull out, that's all that's left. What a waste.
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