I think everyone realizes what a complex landscape this is. There are many factors, both large and small, that contribute to our ongoing issues with organ donation. This is one example of how something that we originally thought and were told was not a very important obstacle to increasing donation has, in fact, turned out to be very important, quite numerous, and quite frequent.
This is work done through combined efforts and led by Tim Caulfield at the University of Alberta. Despite the fact that in examining the legal landscape in every province across the country about the requirement for permission for what happens when you sign up to be an organ donor, and despite your entering into a legal event by signing an organ donor registry, your family can override your own wishes. They could never decide that you can't donate your fortune to a cat when you die, but they can easily say they don't support organ donation by an individual who had a legal entity saying that they wanted to.
This is actually much bigger and more common than we had previously known. Again, it's one factor in many. However, these are the things we can potentially address by looking at each one of these obstacles to donation.