Canada's low deceased organ donation rate not due to lack of public support

Long wait lists and gaps in supply and demand not due to lack of interest

While more than 4,000 Canadians are on wait lists for organ transplants - and every day-and-a-half, one patient dies waiting - Canada's low deceased organ donation rate cannot be attributed to a lack of public support.

As world experts gather next week in Vancouver to discuss strategies for increasing organ donation and transplantation rates, a recent Ipsos Reid poll shows that Canadians are strong proponents of both organ and tissue donation. But confusion about how to declare their support for donation in the current system may be a key factor in Canada's flat donation rate for the past decade. At about 14 donors per million, our national organ donor rate (deceased) is less than half that of the best performing countries.

The poll shows that the majority of Canadians have either made the decision to donate, or are open to it, however few have taken action to register their consent. Further, seven in 10 Canadians cannot name the organization responsible for managing the organ and tissue donation and transplantation (OTDT) system within their province or territory-demonstrating confusion about how to register and with whom.

"The current system saves lives every day, but what this poll tells us is that we have an opportunity to do so much better," says Dr. Graham Sher, CEO of Canadian Blood Services, which commissioned the poll as part of public consultations on system improvements in OTDT . "What Canadians are telling us is that they need a clearer, more responsive system that makes it easy for them to act on their support, and that ultimately respects their wishes."

Other key poll findings include:

- Canadians agree that improving access to organ and tissue donation is a top health-care priority, and that increased education and awareness about donation options for both the public and medical communities is key. They also believe that a physician or medical professional should approach families at the appropriate time to discuss donation options. - While Canadians are united in the need for an improved OTDT system, their opinions differ on potential remedies; for instance: - 88 per cent believe the wishes of a deceased person who has signed a donor card or registered their intent should be followed - regardless of the wishes of next-of-kin - However, only 54 per cent of Canadians favour "presumed consent," in which organs and tissues are considered public good unless one "opts out." Meanwhile, 45 per cent are decidedly opposed to a system that assumes consent without prior consultation. - Most Canadians list inter-provincial collaboration as the top priority for developing an integrated system, to ensure wait times are consistent across the country and that patients have a fair chance of receiving a transplant, regardless of where they live.

This polling information supports data that Canadian Blood Services collected during a series of nine public dialogue consultations held across the country in recent months. In particular, public dialogue participants expressed surprise that wait times for organs vary widely across the country. Similar to Ipsos' data, consultation participants placed a high premium on equality and fairness; and improved collaboration nationwide.

In August 2008, Canadian Blood Services was mandated by the federal, provincial and territorial governments outside Quebec to develop a recommendation for the design of an integrated system to improve organ and tissue donation and transplantation (OTDT) in Canada. Since then, the organization has been consulting broadly with industry experts both at home and internationally, with key patient groups, and with the Canadian public. A series of recommendations is being developed based on those consultations.

In 2008, there were more than 2,000 organ transplants performed in Canada, while at the same time more than 4,300 Canadians remained on a wait list for transplantation. During that period, 215 died without receiving the transplant that might have saved their lives.