House of Commons Hansard #60 of the 41st Parliament, 1st Session. (The original version is on Parliament's site.) The word of the day was organs.

Topics

Organ Donations
Government Orders

10:20 p.m.

NDP

Pierre-Luc Dusseault Sherbrooke, QC

Mr. Chair, I think that we agree on one point and that we are all on the same page when it comes to the figures before us today. We are in a crisis situation because we currently lack sufficient organs to meet needs. That much we agree on, however we also agree that action must be taken. On the other side of the House, members can be heard saying that things need to be done at a more local level, with family doctors and our loved ones, and that we have to discuss this with our families.

I would like the member to also speak about the exact role of the federal government and what the government intends to put forward. This evening, we are having a take note debate to discuss this issue, but does the government have a plan to build public awareness rather than leaving it up to those watching the debate today to talk about the issue with their families? The government should take stronger and firmer action to build awareness. A national strategy is required to enhance organ donation and to build awareness around the issue of concern to us today.

Organ Donations
Government Orders

10:25 p.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

Mr. Chair, certainly the tack that our government has taken, when dealing with the provinces on health care, is to work collaboratively with them to develop strategies that will respect provincial jurisdiction, while at the same time recognizing there is a coordinating role for the federal government to play.

The chair of the health committee spoke earlier today about specific interventions that the federal government was taking with the registry of donors. Those are good examples of what we can do, while at the same time respecting the provinces and their unique role in the delivery of health care services.

Organ Donations
Government Orders

10:25 p.m.

Blackstrap
Saskatchewan

Conservative

Lynne Yelich Minister of State (Western Economic Diversification)

Mr. Chair, would the member like to expand on what kind of investments our government is making to help prevent chronic diseases like cancer and if our government is being innovative in its approach in preventing chronic disease in Canada? The member spoke quite a bit about chronic disease.

Organ Donations
Government Orders

10:25 p.m.

Conservative

Mark Strahl Chilliwack—Fraser Canyon, BC

Mr. Chair, our investments include initiatives such as the Canadian Partnership Against Cancer, which is accelerating cancer prevention and ensuring that cancer programs in all jurisdictions have access to the best information on cancer control.

We are also making investments in innovative approaches to prevention. We want to ensure that best practices are shared. Part of the role of the federal government is to promote that innovation and make strategic investments. We know we have a role to play in working with the provinces on issues like organ donations and prevention and management of chronic disease.

Organ Donations
Government Orders

December 5th, 2011 / 10:25 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Speaker, I have been listening to this debate and it is a good thing we are discussing the issue. I would like before we rise for the evening, however, to come up with some really concrete solutions to this problem.

I have heard people ask, first and foremost, how we get Canadians who have stated clearly that they want to donate, to donate. Ninety per cent say they want to donate, so the big question then is why are they not donating?

What are the things the federal government can do to help them to donate? We should have some concrete solution to that. I would like to suggest one.

Many people have touched on it, and it has to do with looking at some sort of public awareness and public education campaign, which could be done on a website, through articles in newspapers, sending out brochures to physicians or to the public in the way that Health Canada does when it wants to get some issue on board. That is one of the things we could do.

We could let people know that in fact transplants can be 90% successful. What are the ways in which they can offer their organs. Some of them can donate while they are living. Some of them can donate post-mortem. The disease has absolutely nothing to do with it. Their chronic illness has nothing to do with it. Their age has nothing to do with it. In fact, once the organ is set for donation, that is where the people, the physicians and donation and transplantation team, look at that tissue or organ and decide whether it is healthy, whether it is appropriate and whether it is a match or not.

Those are not things for the government to worry about. The government should just help to walk people through the ways in which they can donate and make it as easy as possible. That is just one thing.

We could dispel some of the myths that we know people have with regard to transplantation, religious reasons, et cetera. Transplantation is a big issue. Most people see their organs as a personal part of themselves. Interwoven within that sense of wanting to be able to give freely and generously to save someone else's life, there is that sense that we are removing a piece of ourselves. There are many cultures that associate that with being an important part of when we pass on and whether we want to be intact or not.

Dealing with some of those issues, dispelling some of those myths that most religions do not agree with organ transplantation when in fact they do, is another thing.

There has to be an easy way. There are ways in which the provinces have, as we well know, through transplantation documents or through a driver's licence that we can donate. Many people know about that, but they are also very concerned because again, most people do not like to think there will come a time when they have a traffic accident and have to donate their organs. We are asking people to think ahead.

The ability to help people understand that this is a life-saving thing they are doing, that this is one way of preventing death, is something that would make a lot of people think differently. Public education and public awareness is the first piece.

The second piece in any kind of strategy would be to have the infrastructure and to make it a one stop shopping area. Practically every country in the world has it, including countries that have federal systems like the United States. We have already seen that the council of the ministers of health met in 2001 and set this up. In 2008 it met again and put money into the whole blood system to deal with the issue. The will is there. Let us get it to become a structure that works.

The next thing we need to do is to find out how we match donors across our vast country and how we match people who are in intensive care units and in emergency departments so we have rapid matches, because time is of the essence in donation. That is a really concrete things we can do.

I heard people talking today about the safety of donations. There is enough information now and we have enough scientific evidence, and this should be done on a evidence-based basis and not on a moral, personal or subjective basis.

I heard the question about gay men who had been active sexually donating either blood or organs. The United Kingdom and all other countries have said that given the next tests we have that can predict HIV or hepatitis C very early and very accurately, that we do not need to look at this five year plan that had been set up. In fact one could look at very clear ways of finding out almost nominally in a very objective manner whether this was a piece of an organ or a tissue that could be donated safely.

This is something that scientists and physicians know how to do. They are doing it around the world. Canada just has to get in step and in line with that. We have had the Canadian Medical Association and other surgeons tell us the international criteria. Therefore, let us follow international criteria. Let us be clear that we are not lagging behind in terms of the decisions that we make because these things change regularly.

Safety of donations is another piece.

In the end, we have money within the system we have already, so let us look at a national registry. Let us also ensure that we have a third party that is set up to look at how we standardize procedures. We are not talking about making one province do what another province does. We are talking about clinical procedures, clear safety procedures and other scientific procedures. There should be standardized procedures for having a registry of donors and a registry of donees. There should be standardized procedures for matching. There should be standardized procedures for moving organs from one place to another rapidly. That is very simple thing to do. It is something we can get the third party to set up, talking to all of the transplantation teams and finding out what is the best way to get this to work. This is not rocket science. This is something that can be done.

Everyone has been very clear. We are on the same page and everyone wants this to happen. Everyone knows that if we can save a life, we should be able to do so as clearly as possible. Everyone understands what provincial jurisdictions are. However, everyone understands as well that there is a huge role here for the federal government.

Best practices is another item. If there is a place where provinces can go to check out what other provinces are doing things and what new things are they doing, we will not have to reinvent the wheel every time. Best practices is not an intrusive thing. It is an information database.

Let us get those things in place. Let us get this moving. Let us get people to understand that it is something they must do, that they need to do it and that it is not complicated. It does not cost them any money. It does not infringe on their religious and cultural beliefs. It is a very simple one-stop shopping thing to do.

Some countries have been doing some interesting things. Israel, for instance, has just started an offering incentive. Israel is suggesting that if people indicate they will donate their organs, then if they get sick and need care right away, they will be first in line in terms of getting care themselves when an organ is there. It is kind of an incentive. It is not buying an organ, which I think is very unethical to sell organs on the market.

We need to look at that. How does Canada play a role internationally in ensuring that organs are not for sale to the highest bidder and that kind of black market thing? We have a huge role to play, internationally, ensuring that this is so through the World Health Organization.

At the same time, there could be incentives. No one knows how the Israel incentive is going to work because it has just started, so let us look at this best practice and see if it works. This is something we should do.

We know that Denmark and other countries have different incentives, where if people do not say they do not want to donate their organs, then they are automatically donated. However, that does not seem to help the number of organs on the market, so I do not think that has been proven to be a best practice. The United States does not do that and it has a larger percentage per million of people who donate organs than in Denmark.

Let us not just pick everything. Let us just pick the things that work. Let us look at what other countries do. Let us emulate good practices. However, let us do something, please.

Organ Donations
Government Orders

10:35 p.m.

Conservative

Joy Smith Kildonan—St. Paul, MB

Mr. Chair, I want to go back to the February 2011 CIHR transplantation workshop held in Montreal with 60 participating members from the transplantation community and potential partners who provided valuable information on how best to address the current challenges in the field of transplantation and improve related clinical outcomes through innovative research programs.

I would like the member to expand on one of the recommendations by the group of 60 participating members. They recommended teams and networks that foster collaboration across the fields of research in partnership with public and private sector partners be formed with the purpose to forge the necessary linkages among transplant communities, support common platforms in infrastructure databases, operating procedures and encourage training. It seems to me that this is a very important recommendation.

I know the member opposite is a medical doctor so I think she could address this very eloquently in terms of the importance of what these linkages would be.

Organ Donations
Government Orders

10:35 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Chair, what I have been saying is that we do not need to reinvent the wheel. There are already many ideas on the table. People who know and have expertise in this issue are telling us what other things we could do.

I think what this group is talking about is the standardization of procedures, of getting together to look at how we standardize across the country, how we pick donors, how we match, how we get the process moving cleanly and clearly so we are able to get the organ to the donee as quickly as possible and that everything is safe and securely done and that everyone is on the same page in terms of the best practices.

While we are debating here, I would like to see us all agree that we will do something because the work has been done and the suggestions are there. Let us all have the political will to get it done because it is about saving lives.

Organ Donations
Government Orders

10:40 p.m.

NDP

Pierre-Luc Dusseault Sherbrooke, QC

Mr. Chair, in my colleague's speech—and when she answered questions—she urged members and the government to take action because the situation is, to say the very least, urgent.

A question was asked of the Conservatives, and I would like to ask the same question of the Liberals. What do they think about the fact that people who have had sexual relations with a person of the same sex in the last five years feel excluded—and they are, in my opinion—from the system?

Does she believe that the Liberal Party could address this situation? How could we achieve equality among all persons in Canada, specifically in the area of organ and blood donations?

Organ Donations
Government Orders

10:40 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Chair, I think I did speak to that in my speech. I said that looking at equitable access is really important. Within the last three or four years, there is the ability to have clear and accurate tests done on HIV testing. When I was practising medicine a long time ago, even six or seven years ago, there were a lot of false positives and false negatives. They test were not as accurate then. Now the tests have become very accurate. We need to be able to rely on the tests to tell us whether we should allow donation of an organ or not and not be based on any subjectivity as who is donating the organ, is the organ safe, has it passed all the tests, is it a clear and safe organ to be transplanted.

Other countries have in the last year been moving in that direction. The five-year waiting time is not any more acceptable by most countries. The United Kingdom recently joined in on this. It is talking about moving this agenda forward and looking at a maximum of about a year for that type of donation.

The Liberal Party feels strongly about this. We are the people who brought into the House the amendment to the Canadian Human Rights Act for looking at sexual orientation as a prohibitive ground for discrimination and moved all the legislation thereafter, including same sex marriage. Therefore, for us, the issue of equity, fairness and the use of non-subjective, evidence-based guidelines for how we treat people and how we make decisions is always at the forefront of what we do as Liberals.

Organ Donations
Government Orders

10:40 p.m.

NDP

Dany Morin Chicoutimi—Le Fjord, QC

Mr. Chair, I would like to thank my Liberal colleague for pointing out that organ donation legislation in England is now ahead of Canada's when it comes to persons who have had sexual relations with an individual of the same sex in the last five years.

I would therefore invite the Prime Minister to speak more regularly with his British counterpart. Why has the United Kingdom passed this legislation and progressed on this issue when the scientific evidence is the same in Canada as in England? Scientific evidence abounds in 2011. I hope that the Conservative government will at last show leadership on this issue.

I have a question to ask my Liberal colleague, who is a doctor by profession. Perhaps she raised this issue with her patients in the past. In her opinion, why is the public, generally speaking, so disinclined to donate their organs? Given her professional and medical experience, can she tell us why people are so reluctant to donate their organs?

Organ Donations
Government Orders

10:40 p.m.

Liberal

Hedy Fry Vancouver Centre, BC

Mr. Chair, I think there are about three or four reasons why.

First, people are reticent to donate organs because they are reticent to donate organs, especially living donors who ask where they would be left if they gave one of their kidneys and something happened that made their other kidney go wonky. Therefore people are reticent. It is a natural feeling. However, this is where it needs to be discussed, one on one, to understand that this is not a huge risk.

Second, a lot of people feel it will cost them money. This is a very interesting myth. People think that if they do this then they will have to bear the cost of the whole transplantation, when it is covered under medicare. People need to have that explained.

Third, a lot of people think there is an age limit to donation. I was reading the other day about a 102-year-old woman who donated to one of her grandchildren, and the organ was fine. There are some organs that can still be donated by people, the sclera on their eyes, et cetera. Age really has nothing to do with it, because once the organ is there then all of the people on the transplantation team decide whether that organ is a match, whether it is a safe organ, et cetera.

However, something that is very important is the ability of physicians and primary care providers to sit down, one on one, and talk with their patients about death, life and organ donations. It is not an easy thing to do, so there needs to be some kind of education of physicians and primary care providers to put this on the table and find ways to donate, to discuss it in a sensitive manner, to be able to answer some of the questions patients may or may not ask, or to be able to sit down with a family and talk about this. These are some of the things we need to look at clearly and to decide.

As well, as I said, this is being done in Ontario right now, or the Trillium Gift of Life Network is thinking of doing it, explaining to people who have already signed a donation card or their driver's licence that it is not necessary to go and seek family approval after that. It is a discussion that must happen. Most families say that because it is their mother or father they do not want to allow it, because they do not believe that when the mother or father agreed he or she was thinking clearly. However, sometimes we have to respect the wishes of people, and that needs discussion at the level of the physician and patient or primary care worker and patient.

Organ Donations
Government Orders

10:45 p.m.

Conservative

Harold Albrecht Kitchener—Conestoga, ON

Mr. Chair, it is an honour to have the opportunity to speak tonight to this important issue of organ and tissue donation.

My comments tonight will no doubt come from a different perspective than most of those who have already spoken. I do not serve on the health committee, nor do I presume to be an expert on organ transplant issues. So I ask for the indulgence and the patience of my colleagues as I share some of my personal journey over the past seven months.

On May 2, election night, as my wife, Betty, and I were watching the early results of the election, along with a campaign volunteer, Betty suddenly experienced a headache. Within seconds she collapsed to the floor, and while she was breathing normally and had a strong pulse, there was no response. Minutes later, following a 911 call, local volunteer firefighters from the New Dundee detachment were on the scene to provide assistance, and they were followed very closely by EMS personnel. Betty was taken by ambulance to Grand River Hospital, placed on life support, and immediately transferred to a major health centre for more specialized care.

ICU personnel and surgical specialists cared for her and explained in some detail that Betty had experienced a spontaneous intracranial hemorrhage and that, in spite of surgical intervention attempting to stop the bleeding, their best efforts had been unsuccessful. The intense bleeding had applied extreme pressure to sensitive brain tissue and brain function had ceased. After consultation with neurosurgeons and ICU doctors regarding Betty's neurological death, we now were faced with the question of the possibility of organ and tissue donation.

We were then introduced to a team of very compassionate personnel representing the Trillium Gift of Life Network. They presented the options to us and provided the answers to all the questions that were raised by me or by my three adult children. There was no doubt in our mind as to what Betty would want to do. We knew that she would want to continue giving in the same spirit of generosity in her death as she had always done in her life.

Betty and I had also discussed this issue openly each time we renewed our driver's licence and had always both agreed that should anything happen to either of us, which would open the question of organ donation, we would want to help in that way.

As I reflect on the difficult journey of our grief over the past seven months, that journey has been made less difficult by two key factors: first, our personal faith journey as followers of Jesus Christ; and second, our decision to follow through on Betty's wish that upon her death, if possible, her organs be donated.

I will briefly expand on both of those factors. As it relates to the tragic, premature loss of life, there are no easy answers, but these past seven months have been possible because we possess a profound sense of hope.

As I said just a little over a month ago in the chamber in regard to suicide prevention and Bill C-300:

Hope is dependent on having a sense of connection to the future, even if that future is very short-term.

Hope is the oxygen of the human spirit; without it our spirit dies.

This is a quote from Margaret Somerville of McGill University.

Each of us can relate to the importance of having hope in our lives. That hope may be a very short-term hope, such as getting through grade 5, or graduating from high school, or getting a driver's licence for the first time, or the upcoming weekend trip. For people of faith, a longer term hope, in fact an eternal hope, is ours because of our belief in the reality of the resurrection.

A colleague in this chamber recently used the phrase “death shall have no dominion”, crediting the phrase correctly to Dylan Thomas. In fact, this phrase finds its origin in the scriptures in the Book of Romans, chapter 6, verse 9, in the context of Christ's victory over death, a victory offered to each of us. My ultimate hope is in this reality that I will again see my wife, Betty, who left this earth just seven months ago yesterday.

I will return for a moment to that hospital. It was clear that Betty's physical life was over. Brain activity had stopped completely. We knew instinctively that the Betty we had come to know and love was no longer there. Her spirit was still very much alive but her body was only breathing with mechanical help. What to do?

Again, our faith has its foundation in the Christian scriptures, which uses many different metaphors for the physical body. It is referred to as a tent, a house, a temple, or even as clothing for the spirit within. So if the person who lived in that temple or had occupied that house or camped in that tent was no longer here to need any of those things, why would we not share them with someone in need?

Why not help out one of those thousands of people who are currently on waiting lists for a specific organ? Many of those waiting are still in the prime of life. An organ donation can make the difference between life and death. Our decision, while not easy, was made lighter by knowing that someone else would possibly receive the gift of life even as we journeyed into our own grief and loss.

Was there a downside to agreeing to organ donation? Yes, there was. We had to prolong the inevitable by agreeing to multiple tests in order to determine if in fact the organs were healthy and suitable for transplant. There were detailed personal history questions in order to mitigate any risks to potential recipients.

Let me assure members of this House and Canadians that they can rely on the safety of organ transplants in this country. This is because of Canada's strong organ transplant community and Health Canada's work in establishing rigorous safety requirements through the implementation of the safety of human cells, tissue and organs for transplantation regulations.

Today in 2011 Canada is now seen as a leader in the area of transplantation safety. This is reflected in the fact that our standards are recognized by the World Health Organization.

The additional tests required the continued use of mechanical means to keep her breathing for another day or more in order to conduct those tests, and then to allow arrangements for transplant teams to be put in place.

All through this, however, while sitting at Betty's bedside, meeting with family and friends in the intensive care waiting room and having Trillium Gift of Life personnel work through our intense grief with all of us, we were carried by our faith and by the knowledge that some good would come out of this very difficult time.

Over the past seven months, the resources of Trillium Gift of Life Network have been incredible. The network followed up regularly with letters of support, offering access to resources, letting me know the health of the organ recipients. Five people have received the gift of life through organs that were transplanted: heart, liver, lungs and two separate kidney recipients. In addition, others have also benefited from the gift of her eyes, bone and vessel tissue which will aid in the transplant process.

Trillium Gift of Life has also sent lists of books and other resources written for people who have experienced the loss of a loved one. One of those books on the recommended reading list is entitled, A Grace Disguised, written by Jerry L. Sittser. I highly recommend this book for anyone grieving. I have purchased more than 20 copies of it and have shared it with family and friends.

We know the need. Four thousand Canadians are waiting for organ donations at any given point. In Ontario alone, over 1,500 people are waiting for a life-giving transplant. Over 1,000 of those people are waiting for a kidney transplant. It is easy to register one's intentions to donate. In Ontario, one simply goes to the website beadonor.ca. Elsewhere in Canada, one goes to www.transplant.ca.

Right now only 20% of Ontario residents have registered their intent to be an organ or tissue donor. Why not go online now and register? In addition to registering, it is important to discuss this matter with one's family members. I ask everyone to please discuss it with them, too. This decision could very well save a life and offer hope.

I know that because of our decision to donate there are now at least five people enjoying fuller, richer lives and even more who are benefiting from tissues transplanted. We are in a death-denying society. No one wants to think he or she will die before 80 or 90, and because of amazing medical advancements many people will live to that age or even beyond. However, we have no guarantee as my family discovered so quickly and with no warning of any kind.

Thousands of adults and children are counting on us and their fellow Canadians to give the gift of life. It is time we as a nation closed the gap between the need for lifesaving and life-enhancing organs and the supply of organs available. Why not take steps now to make a difference? It could be anyone, a son or daughter or granddaughter, who will be the recipient of someone else's good decision to donate their organs.

This past weekend I walked in a Christmas parade with a heart and double-lung transplant recipient. I met many other recipients who have been blessed with the gift of life through organ transplants.

I know that every one of the recipients is extremely grateful for the fact that someone else took the time to register to be a donor, and now they as recipients are enjoying the gift of life.

Organ Donations
Government Orders

10:55 p.m.

NDP

Pierre-Luc Dusseault Sherbrooke, QC

Mr. Chair, I thank my colleague for his excellent speech and for sharing his personal experience. I have a rather simple question for him. I may have missed it, but I have not heard any mention of organ trafficking since the beginning of the debate. This is a serious problem around the world. Make no mistake, it happens in Canada too. People sell their organs on the black market. This topic was not brought up today, and I would like to know what the government thinks about this problem.

In Canada, there are not enough organs for the people who need them, and there are some people who traffic organs, which is illegal, of course. I would like to know what the government plans on doing to resolve this situation. I think it is something very serious. The government should play a role in taking these organs and giving them to people who need them, and in ensuring that the traffickers who make money from this illegal trade are punished appropriately. I would like to know what my colleague thinks about that.

Organ Donations
Government Orders

10:55 p.m.

Conservative

Harold Albrecht Kitchener—Conestoga, ON

Mr. Chair, as I indicated at the outset of my speech, I do not profess to be an expert on organ donation and transplantation, but I know that Canada has some very stringent guidelines in place as it relates to the safety of transplants. In fact, I mentioned in my speech the safety of human cells, tissues and organs for transplantation regulations. These regulations outline some of the most safe and medically sound methods of organ donation and transplantation.

The safety of organ donation and transplantation is a responsibility shared by numerous parties across Canada. I believe there are some 37 registered organ transplant programs in Canada. Operators of these programs are responsible for declaring that the organs they distribute are safe for transplantation in Canada. We have some very stringent guidelines in place. I share my colleague's concern that we certainly do not want to open up the possibility of a black market for access to organs for transplant purposes.

Organ Donations
Government Orders

11 p.m.

Conservative

Joy Smith Kildonan—St. Paul, MB

Mr. Chair, I have to say the member's speech was possibly the best one I have heard in a long time in Parliament. It was very profound. Our hope is in the Lord and that is the most important thing. I find it ironic that I am standing in the House of Commons at this late hour and my colleague, who spoke so eloquently, had a wife who gave life to five people. I stand beside him as a very grateful person because a donor graciously donated stem cells so my husband could live.

In this country we foster a lot of confidence in the safety of human organs for transplantation. As we know, the federal government is responsible for the safety of donated organs from the perspective of product safety. The safety of human cells, tissues and organs for transplantation regulations came into force December 7, 2007, as was mentioned earlier.

Does the federal government regulate how donor organs are allocated across Canada? That is the other aspect to it.