Less than 3% of Nova Scotians have opted out of being organ donors

Heading into the launch of Nova Scotia's presumed consent organ donation program last January, Dr. Stephen Beed was hopeful it would be embraced by people in the province.

That optimism is being validated based on the program's first four months.

From the launch on Jan. 18 until May 20, just 28,702 people have opted out of allowing presumed consent, less than three per cent of the province's population.

"I do not expect the numbers to go up dramatically," said Beed, medical director of the province's organ and tissue donation program, Legacy of Life.

"They'll dribble up, but to get to 70- or 80,000, seven or eight per cent of the population, for example, I don't think we're going to go there."

• One person dies, another person lives

When Nova Scotia passed legislation creating the reverse onus in 2019, it became the first jurisdiction in North America to do so. Now, rather than requiring people to sign up to become organ donors, they are presumed to be, with the ability to opt out.

The change does not apply to children, people who don't have the capacity to make a decision for themselves and adults who have lived in Nova Scotia for less than a year. Even then, families ultimately have the final say at the hospital.

Already there has been an example of a donation that happened because of presumed consent.

"It's what we hoped, even expected, but boy oh boy, hoping and expecting are not as good as actually realizing," said Beed.

There is work that remains.

The pandemic has slowed the ability to train new staff and get them in place as part of the expansion of the program.

Expanding donor physician network

Last year, several donation physicians were brought into the fold and there are three more expected to start soon. By the end of the year, Beed expects most of the province will be supported by local donation physicians.

What that means is intensive care units around the province will each have a doctor with an interest and extra training in donation activities.

"Our hope over time is that they will become a well-identified helpful resource from an educational perspective and also from a quality assurance perspective," said Beed.

"They know their communities very well. They will be able to interact with their neighbours and their colleagues and advance the donation message as a local, trusted voice."

Collectively, they'll work to increase donations across the province. At some point, the aim is also to expand some services that so far only happen in Halifax.

Beed can see a time when donations related to medical assistance in dying and cardiocirculatory death could happen at regional hospitals. Beyond increasing donations, Beed said such a change would also benefit families because it would mean they would no longer need to travel to Halifax after a loved one dies.

'I think we're going to a good place'

"We're not ready for that, but that's where we think we're going in the next little while," he said.

It's too soon to pass judgment on what the legislation will mean to donor rates in the province, but Beed said things look positive.

"I don't want to draw conclusions prematurely, but I think we're going to a good place and I think in a year or two or three, we'll have a stable donation rate that is definitely higher than where we were and that'll be great for the province," he said.

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