Debates of April 19th, 1996

National Organ Donor Day Act

[Dan McTeague, Liberal, Ontario, ON]

moved that Bill C-202, an act respecting a National Organ Donor Day in Canada, be read the second time and referred to a committee.

Mr. Speaker, it is ant honour for me to rise today to launch the debate-which I hope will be positive-that will among other things improve the health and future of many people from

coast to coast, whether they live in Quebec, Ontario, western Canada or the maritimes.

Bill C-202 would designate a national day to recognize the importance of organ donation.

My desire to put forward this private member's bill came as a result of a very real, very human event that took place in my riding on April 21, 1994.

A young boy by the name of Stuart Harriott of Whitby, Ontario was unfortunately involved in an accident with a vehicle. As the young boy was in the last days and hours of life, his parents, his aunt and other relatives tried to determine how best to resolve their terrible grief. The doctors had told them that the young boy would eventually pass away and he did succumb to his injuries.

Rather than seeing this tragedy for what it was, Linda Rumble and Stuart Harriott's parents decided that they would begin a campaign to initiate something that would provide, if there ever is one in this world, a silver lining to such a tragic event.

At their insistence and the insistence of many organizations I have had the privilege of speaking to over the past year, we have before us today an opportunity as Parliament to discuss and perhaps approve an action Parliament recognizes on a given day, April 21, the importance and significance that in giving of one's life we may also give life to others.

The bill is about public education and awareness. Every year in Canada from coast to coast, 2,500 people need the gift of life. However, only 300 transplants on average are given. This leaves a tremendous shortfall.

While many organizations, from the Kidney Foundation to the Multiple Organ Retrieval Exchange Group, the Canadian Association of Transplant Patients, the Canadian Cystic Fibrosis Foundation, the Canadian Liver Foundation, the Heart and Stroke and Lung Association, to the Canadian Medical Association and many others work to raise the awareness of Canadians of the need to sign their donor cards, many may do not enjoy the benefits and continue to suffer.

The House of Commons has an opportunity to put aside the traditional debate and often divisiveness that exists and provide for once an opportunity to allow people who are suffering today the hope that perhaps down the road they will be able to receive one, two or several organs. Some of these young children who received the gift of life from Stuart Herriott will also be able to enjoy their future.

Perhaps this is more important because it is not just that it affects and sounds like it is one of those motherhood issues. I think each of us in the House knows of constituents and families afflicted and affected by a debilitating disease or by accidents or by trauma.

I was very surprised to learn that one of our former clerks who worked on many committees for years, a well known individual, G.A. Sandy Birch, is a recipient of a heart. I a saw him recently at a function held in Ottawa where 35 other individuals had been given the gift of life, many of them with our colleague in the other place presiding at the transplant, the hon. Dr. Keon.

I was quite impressed to see how important and how close to home such examples of transplants can be in our own neighbourhoods.

I believe the public awareness and education programs such a bill would bring about would address very firmly some of the misapprehensions individuals have about transplants. Some will be concerned from a religious point of view, and I will address that.

Much of this is based on what some would consider simply confusion or ignorance surrounding the religious impact on the issue of organ donation. It may surprise many colleagues to learn that virtually every major religion in the world permits, and some actually encourage, organ donation and transplants.

Hindus are not prohibited by religious law from donating organs. Muslims support organ transplants and donations as long as they are done with respect for the deceased and for the benefit of the recipient. Judaism teaches that saving a human life takes precedence over maintaining the sanctity of the human body in terms of organ donation. Direct transplantation is therefore preferred.

In Christianity, Protestants respect individual conscience and an person's right to make decisions about their body and that resurrection does not require making the physical body whole again. Catholics view organ donation as an act of charity, fraternal love and self-sacrifice.

Some are also equally concerned about the question of safety. The importance of ensuring the safety of organ transplantation is of paramount and absolute concern. Research is being conducted examining the issue of reducing the risk of a recipient's contracting diseases such as hepatitis B and C and HIV from transplants.

In October 1995 the national consensus conference on the safety of organs and tissues for transplantation brought together a broad range of experts in the field of transplantation. The conference was successful in achieving a consensus on accepting in principle a Canadian general standard on safety of organs and tissues for transplantation. At the same time a risk management regulatory framework was proposed.

I am confident that more attention and study will be given to the issue of improving the safety of organ transplants.

In the intervening period since I introduced this bill under a different name in the previous session I have received a lot of correspondence from members of Parliament from across this great land.

Support for Linda Rumble and her initiatives have been received from many members, including the members for Saint John, Peterborough, Winnipeg North, London East, Vancouver Centre and Saskatoon-Humboldt.

Mr. Speaker, while we agree to the need for a day when we can pay respect to the individuals who have given life, perhaps some time down the road your good Chair and office might permit an honour role to recognize every year those who in laying down their lives have actually provided hope for many others.

It is my belief this bill does what other organizations cannot do individually. They cannot draw the attention of all Canadian people to sign their donor cards and to address the inhibitions of organ donation, for it is not something which should be done with trepidation, but with honour. When we pass on from this great planet, it is my belief there are opportunities for us to know that some of us will live in the lives of others.

I was also touched by some of the more immediate examples of what organ donation has done for many people, even among families. Glenn DeMille is a well know heart transplant recipient who helped to organize many events in the Ottawa region to draw attention to, at least from a local perspective, the need for organ donation.

Mr. DeMille received a heart transplant several years ago. However, most people do not know it is his son's heart which lives within him. Glenn DeMille did not know his son had signed a donor card. After his operation he was informed of the transplant. Mr. DeMille smiles because he feels like and has the energy of a 25-year old. Mr. DeMille will continue to be a driving force locally.

Perhaps we need a national force in which the division which often appears in the House of Commons and in committees is put aside for one day and parties will actually say there are some issues which transcend partisan considerations.

I am submitting today that Parliament can do what individual organizations cannot do. While it is true some groups and organizations designate weeks in which they recognize specific causes on a regional, local or provincial basis, we have never been able to pinpoint a specific day. In my view it should be April 21.

I ask this House to give my bill serious consideration and to support its implementation so that present and future generations can receive the gift of life.

[Christine Stewart, Liberal, Northumberland, ON]

Mr. Speaker, a point of order, I simply want to confirm to the House that next Tuesday will be an allotted day.

[Madeleine Dalphond-Guiral, Bloc, Laval Centre, QC]

I am pleased to participate in this debate today, Mr. Speaker, on the bill put forward by the hon. member for Ontario, a bill designating April 21 National Organ Donor Day.

I will start with a real life story. The story is set in Montreal's Sainte-Justine hospital. The year is 1959. It feels almost like yesterday. I was about to graduate from nursing school. Pierrette was a patient of mine. She was 14 years old and had been suffering from kidney failure for several years. Thirty years ago, haemodialysis and kidney transplants were still in the realm of science fiction. All this to say that Pierrette was dying. All she wanted was to sleep through the night but, one night, she went to sleep never to wake up again.

In those days, cases like Pierrette's were hopeless and therefore went untreated. The feeling of helplessness was extremely frustrating for all of us. Why her and not me? Science has made giant strides since. Over the course of almost 30 years of professional activity entirely dedicated to paediatric care, I finally saw hope rekindled in the hearts and minds of parents and caregivers.

Today, increasingly sophisticated technologies make heart, liver, lung and pancreas transplants possible. What was a virtually impossible feat in 1960 has become, today more than ever, a challenge to take on.

In 1995, in Quebec alone, 375 persons received the invaluable gift of life because 117 healthy people like you and me agreed to give the gift of life after their own life was over. There are nevertheless more than 500 Quebecers who are still waiting for a transplant and, across Canada, only 40 per cent of those who need a transplant actually undergo the operation. Scientific progress notwithstanding, the biggest problem remains the insufficient supply of organs to meet the demand.

According to Québec-Transplant, one of the factors contributing to this shortage is undoubtedly the fact that only an infinitely small number of possible donors meet the requirements for organ donation. In 1995, among the many donors referred, only 117 could be used to meet part of the transplant needs. So, if there are more donors, there will also be more people who will benefit from a long awaited organ transplant that will improve their quality of life.

This is why this bill is so important. One way to increase the number of donors is to run public awareness campaigns on the importance of organ donation. In that field, the most sophisticated

technologies are useless if people refuse or forget to give the gift of life.

Instituting a national organ donor day would help organizations such as Québec-Transplant and the Canadian association of organ donors to intensify their campaigns to recruit organ donors and to stress the importance of volunteer work in that sector.

This issue is very dear to me, partly because for four years now, Laval, which is the second largest city in Quebec and which is were my riding is located, has been running a campaign in April to recruit organ donors. I am proud to participate in that event as honourary copresident. I can see the positive impact of such a campaign in terms of encouraging people to pledge to donate organs, but also on the volunteers working in that sector. The organ donor month in Laval also provides an opportunity for various interested parties, including volunteers, medical teams and organizations, to consult each other to promote organ donation.

Police officers are a good example. I would like to take this opportunity to express my deep appreciation to police officers in Laval, who are serving this cause by transporting organs and thus contribute to saving many lives. Since 1993, about 50 police officers have been called upon 325 times and have travelled over 39,000 kilometres to transport donor organs.

But the main goal is public awareness, so that people will sign they donor card and talk about it with their relatives and friends.

Organ donation is a sign of solidarity with people who need an organ transplant to stay alive or get a better quality of life. It can also give a meaning to death, because it is a gift of life.

Only through sharing and generosity can we solve the shortage of organs for transplants. Sooner or later, we all have to come to grips with the reality of death, our own or that of a loved one. The loss of our loved ones is always a cause for grief, but organ donation is a gift of life that can bring hope and peace.

However, some elements like the lack of knowledge about the organ shortage or the emotional drive to keep the body of the deceased intact all hinder an increase in transplants and make it crucial, at least for the people waiting for a transplant, that information and awareness campaigns be launched.

This is why I intend to submit to the health committee an amendment to Bill C-202, asking Parliament to recognize April as organ donor month, as is the tradition in Laval.

I think that, because of the extent of the organ shortage and the importance of this issue, we need to set aside a whole month to educate the public. Health is not only about science and technology. It is also a question of awareness and reflection and caring. Since life gives us all kinds of opportunities, I think we should also give life a chance.

[Dale Johnston, Reform, Wetaskiwin, AB]

Mr. Speaker, I am pleased to speak today in support of Bill C-202 which seeks to designate every April 21 as national organ donation day.

Oftentimes we are reminded there are only two certainties in this life, death and taxes. We can count on this government to ensure that we pay more than our fair share of taxes and at the same time we have learned that we can postpone death. While we cannot put it off indefinitely, it is possible to postpone it.

Advances in medical technology have allowed some people to do just exactly that through organ transplant surgery. It has given Canadians from all walks of life from all across the country a second chance at life.

Organ donation operations are no longer an experimental procedure. They have become so successful that the number of people on waiting lists in Canada far exceeds the supply of available organs. I commend my friend from Ontario for introducing this bill. It increases the awareness of this problem in Canada. As has been pointed out by my colleague from the Bloc, it is to give the gift of life even though the person is no longer there to see that gift being given.

Since organ transplants began in Canada, some 18,000 operations have been performed. In 1984 there were 500 transplant operations while 10 years later in 1994 over 1,400 such operations took place. That is the good news. The not so good news is that in 1992 there were over 2,000 people on lists waiting to receive organs and by 1995 the number had grown to 2,600.

As members of Parliament we should take the initiative to promote the benefits of organ donation. There are common misconceptions with regard to organ donation which I think we have a duty to dispel.

For instance, there are those who believe it does little to save lives and restore health but the facts indicate the contrary. Organ donation is a proven life saver with success rates ranging from 85 to 95 per cent. That is a pretty good gamble for somebody who requires a kidney. It is not what one would call routine surgery but it is certainly not experimental either.

Another common misconception is that organ donations and transplants are a financial burden on health care, that they are costly. Organ donations and transplant operations not only save lives but they save dollars as well. The issue of health care dollars, as was evidenced by our previous debate, certainly is a timely topic

at the moment. Health care dollars are becoming more and more scarce all the time.

As an example, for those suffering from kidney disease, a transplant operation would cost in the neighbourhood of $20,000 plus about $5,000 a year for follow-up treatment, whereas renal or kidney dialysis for the same person would cost around $50,000 a year. Coupled with that, if the person has a functioning kidney their quality of life and their productivity is certainly a lot better than it would be if they had to rely on a kidney dialysis machine.

Another reason I encourage members to support this bill is that it will increase public awareness. The government will have to get the public thinking about organ donation if the gap between availability and demand is to be filled.

One of the biggest obstacles is the lack of communication between family members. Not that I want to do a commercial for Mutual Life Assurance Company of Canada but it did conduct a survey which found that only about half of Canadian families have ever discussed the issue and the circumstances surrounding organ donation. That is to say that only about half of them even discussed the matter and very few of those actually took the action of filling out a donor card, which is the first step.

Even though an individual may have signed the donor card, the family of a person who has just expired may express concerns and objections about the donation of a loved one's organs. As a matter of professional practice, the doctor will defer to the family's expressed concern. The result is that the organs will not be donated. They will not be used to benefit a waiting recipient.

One solution to this quandary is to have both spouses, the guardians or people who are indicated as next of kin in the event of death sign the organ donation card so that there will be agreement on whether or not the organs are to be donated. This will increase the timeliness and of course with organ donations timeliness is very important.

Perhaps there is a need for a national registry of potential organ donors. In case of fatal traffic accidents for instance, the personal effects including the driver's licence may be separated from the victim. If a person has filled out the organ donor card on the back of their licence, it does not really solve the problem if the driver's licence is in one place and the body is in another. Often too much time elapses before this is realized and by that time the organs may not be suitable for donation.

Another option is to have prospective organ donors registered with the Canadian Police Information Centre. There is access to the Canadian Police Information Centre all day every day. It is registered across the country. All that is needed is the authorization of the solicitor general and the police authorities in order to carry out this step.

Such measures would address waiting lists which continue to grow and lives that are needlessly lost as a result. In 1995 alone 1,114 Canadians died because they had not received a suitable organ for transplantation, an organ that would have restored their health.

I was astonished to learn that Canada has one of the lowest organ donation rates in the world. In Canada there are only 14 donors per million whereas in other countries the average ratio is between 20 and 30 donors per million. There is a lot of work to be done. As I have said before, that is the goal of my colleague from Ontario who would like to raise awareness of this problem and increase those numbers to make available more and more organs for donation.

Earlier I mentioned new initiatives the government should consider. In the interim Canadians should be made aware that they can do more than sign their driver's licences and register as donors.

Mutual Life Assurance Company of Canada sponsored an organ donation campaign called "By Mutual Consent: Breaking Barriers to Organ Donation". A number of non-profit organizations such as the British Columbia Transplant Society, the Kidney Foundation of Canada, the Canadian Transplant Society, Organ Donors Canada in Alberta and the Canadian Association of Transplantation are active in promoting and co-ordinating organ donation efforts.

Bill C-202 is an example of an effort to do more. It is a reasonable and worthy initiative which could complement other efforts designed to motivate people to give the gift of life. Along with national donor week which we celebrate at this time each year, which apparently is not exactly a national donor week but an Ontario donor week, the member for Ontario's initiative would promote and encourage discussion on the issue surrounding organ donation.

Reformers are pleased to support this bill as it would contribute to efforts to address this need proactively. In doing so it would save lives and improve the health and the quality of life of many Canadians. It would conserve precious health care dollars and encourage the public's awareness and discussion. I urge all members to support the bill, consider the issue themselves and discuss it in their constituencies.

After all, healthy Canadians are more productive Canadians. We are very concerned about the quality of life in Canada. If we as individuals or as a group want to ensure people will not be on waiting lists for organ donation transplants, we should be proactive in our approach.

[Joe Volpe, Liberal, Parliamentary Secretary to Minister of Health]

Mr. Speaker, I am pleased to be a part of this debate. I compliment my colleague from Ontario riding for making not

only a very persuasive and compelling dissertation but one that was moving as well.

It is most unfortunate we have to make reference to such personal tragedies as that suffered by the Rumble family. We will try to take a positive view, as my colleague from Ontario did, and say that perhaps from one human tragedy we can do something that is worthwhile for the rest of us.

On the question of transplants and organ donations, the House may be aware that the kidney transplant is the oldest of the solid organ transplant procedures. The first successful kidney transplant between identical twins in Boston in 1954 ushered in the new era of transplantation.

Improved surgical techniques and new drugs to fight rejection enabled Montreal surgeons to transplant kidneys between unrelated persons in 1963. I mention this because I would hope that all those who are interested in the issue, not only from the political realm but also in society as a whole, would keep an appreciation of the activity of Health Canada and all Canadians working in this area.

This first transplant was followed in 1967 by a heart transplant performed by Dr. Christiaan Barnard of South Africa. A year later, in 1968, the first heart transplant was performed at the Montreal Heart Institute.

The use of the anti-rejection drug cyclosporin in the 1980s greatly improved the success of transplantation and contributed significantly to the growth of this procedure. Today transplantation of both organs and tissues has become an important part of health care and has contributed to improving the life expectancy and quality of life of thousands of Canadians.

One of the key barriers to transplantation remains the availability of suitable donor organs and tissues, as other speakers have noted. In fact, about 2,200 Canadians are currently waiting to receive an organ transplant. Waiting times vary depending on the specific organ and tissue required for a transplant.

The overall rate of organ donation in Canada is regrettably low: about 14.7 per million population as of 1994. Yet that represents roughly a 20 per cent increase from the 12.1 per million population in 1992.

Still, by international standards, as others have indicated, Canada could and should do better. While our rates are comparable to those of Australia, the United States has a donation rate which is about 50 per cent higher and Austria's rate is double that of Canada's.

According to a 1994 public opinion survey conducted by the Angus Reid group, 77 per cent of Canadians indicated a willingness to donate organs. Unfortunately, only 58 per cent reported having signed a donor card. Still this did represent an increase over the 1993 and 1992 levels, which were 56 per cent and 53 per cent respectively.

There is a considerable opportunity gap between those expressing a willingness and those who actually act on that willingness. However, what is very encouraging is that of those who had not signed a donor card, 54 per cent indicated they would do so if offered the chance and the opportunity to so sign.

That survey, by the way, pointed out some misconceptions about organ donations which may be impeding behaviour in this regard. I will cite a few examples.

Forty-three per cent of Canadians reported assuming that only those in excellent health would be able to donate. Thirty-eight per cent thought that organ transplants were more costly than keeping a patient alive through other means, such as kidney dialysis or drug therapy. Twenty-eight per cent thought that the organ donation would result in changes to funeral arrangements. Seventeen per cent thought that organ transplantation was not the most effective medical treatment for organ failure.

Despite these misconceptions, concerted efforts are and have been under way for some time in Canada to improve the public's awareness of and willingness to become organ donors. Among those taking a leadership role in this regard have been national and non-governmental organizations, such as the Kidney Foundation, as my colleague from Ontario pointed out, the Heart and Stroke Foundation, the Liver Foundation, the Lung Association and the Cystic Fibrosis Association. In addition, several national associations, including the Canadian Medical Association and the Canadian Nurses Association, promote organ and tissue donor awareness through their professional journals.

These and other national organizations, including Health Canada, are members of the Canadian Coalition for Organ Donor Awareness, also known as CCODA.

Together, national and provincial governments and non-government organizations currently organize various public awareness and education seminars during national organ donor awareness week, which is the last full week of April.

My colleagues on both sides of the House have rightly pointed out that so far there has not been the rate of donation that we could expect to make such programs completely successful. That having been said, local hospitals and community groups have organized campaigns to heighten understanding and awareness of the importance of organ donation. If the House will permit, I will take the opportunity to give an indication of one such organization in the immediate vicinity.

The Ottawa-Carleton chapter of the Canadian Liver Foundation will host its seventh annual celebration of life service in appreciation of organ donors and their families this Sunday, April 21, at Christ Church Cathedral on Sparks Street. One should note that the church is wheelchair accessible from Queen Street. All are welcome.

It is organizations like this, activities like this, that give us a better appreciation of needs everywhere.

Within Canada the public and stakeholders in the organ donation programs have accepted the need for specific focus each year on efforts to promote public education about organ donation. This is an important health care issue for all Canadians and one that many national and provincial organizations are actively pursuing. It is one that Health Canada has been pursuing for a long time. We will continue to pursue it with the support of colleagues on both sides of the House and from organizations, provincial, municipal and non-governmental, everywhere throughout the land.

I thank the House for its attention on this most worthwhile topic.

[Leon Benoit, Reform, Vegreville, AB]

Mr. Speaker, I rise today to speak on private member's bill C-202, an act respecting national organ donor day in Canada.

I would like to thank the hon. member for Ontario riding for bringing this private member's bill to the House. I believe it is a very worthwhile bill for several reasons.

First, there is merit in having recognition of something as important as donating an organ. The public becomes more aware of the issue, of the shortage of organs and of the long lists of people who are waiting to receive an organ so they can have their life improved or prolonged. Therefore I would like to congratulate the hon. member for Ontario for bringing this motion forward.

Any kind of media attention that can be brought to an issue like this will help. I seldom would wish this for a Liberal member of Parliament, but I wish him all kinds of extremely positive coverage on this issue. It can only help to make people aware. Perhaps it will encourage some people within their families to talk about the possibility of organ donation should one of them die prematurely.

As I was coming here on the little green bus from the Confederation Building I was thinking about how I would feel. I have five children, three boys and two girls. I have identical twin sons and also a twin son and daughter. The identical twin sons came to mind. If they were, God forbid, in a serious car accident-they are 17 years old so I cannot help thinking about that possibility-if they were both critically injured and one of them died and could through donating an organ prolong the life of the other, I could not help thinking what a terrible loss it would be if the arrangements had not been made so that the people who arrived on the scene did not know immediately that the intent was that my sons wanted this to happen.

As well, I could not help thinking of the good feeling and possibly the way that this could make it a little easier to suffer through the loss of this child, knowing that a part of this child who had died could remain alive in the life of the other.

Therefore, I congratulate the hon. member opposite for bringing this motion forward. I wish him all the media attention that he can get on this. Any kind of education and awareness that we can help promote on this issue is extremely valuable and will save lives.

While I congratulate the member for bringing this bill forward, I do not think it is enough. What we should do in the House is actually draft a bill that will in a far more substantive way allow, provide for and encourage more people to donate organs so that there is not this long waiting list we have in Canada now.

It is important on an issue like this, if we are to debate it in the House, that it be done in a non-partisan way. I am talking about a bill which will become law and which will provide for a much better organ donation system than we have now. It is important for that to be done in a non-partisan way.

In legislation the Liberal government brought forward in 1994 there were some changes made to chapter IX of the standing orders. One change allows the government to put a bill before committee before second reading. This legislation has been used. A change to Standing Order 68(4)(b), a provision which has not yet been used, allows a private member's motion to be put before committee before second reading so that legislation can actually be drafted by committee.

I am in the process right now of presenting a private member's motion to Journals which will ask the House to send a motion dealing with organ donations to committee before second reading so that the appropriate parliamentary committee can actually draft the legislation, which will help take some of the partisanship out of the process. This will enable the committee to draft the legislation which will help in a very substantive way to make the organs needed readily available.

I will read this section of the standing orders:

A motion by a private member to appoint or instruct a standing, special or legislative committee to prepare and bring in a bill, pursuant to section (1) of this standing order, shall be considered as a motion under Private Members' Business and shall be subject to the procedures in that regard set down in Standing Orders 86 to 99, inclusive. A motion by a member other than a minister of the crown to concur in the report of a committee pursuant to this section or to section 4(a) of this

standing order shall also be taken up as a motion under Private Members' Business pursuant to the aforementioned standing orders in that regard.

This section will allow this process. I hope my private member's motion, should it come before the House, will add something even more substantive to the bill presented by the hon. member for Ontario. I am in the process of presenting this motion to Journals. I hope it will be unanimously supported when it comes to the House.

I will shorten my comments because many people before me have talked about statistics and have expressed very well the need for an improvement in the mechanism. They have talked about the long waiting lists. They have talked about people who have died waiting for an organ donation. I believe all of us know someone who has died unnecessarily because organs were not available.

I have 295 organ donor cards which have been provided by the Kidney Foundation of Canada. I ask for unanimous consent of the House to have these organ donor cards transferred to the table so that all members of Parliament can show by example the importance of everyone who is willing to sign an organ donation card. In that way the list of people waiting for organs will be shortened substantially and fewer people will while die waiting for organs.

[The Deputy Speaker]

Colleagues, is there unanimous consent to allow the member to do as proposed?

[Some hon. members]

Agreed.

[The Deputy Speaker]

So ordered. The cards will be transferred to the table.

[John Murphy, Liberal, Annapolis Valley—Hants, NS]

Mr. Speaker, I am pleased to have the opportunity to speak on this important issue. I thank my hon. colleague for bringing this important issue forward in the House of Commons.

Organ donation and transplantation is an essential part of health care in Canada. While there have been improvements in the rates of organ donation in Canada, we still lag behind other industrialized countries including Austria, Spain, Belgium, the United States and France.

Health professionals are keenly aware of the importance of organ transplantation both to save lives and often to reduce ongoing expensive treatment costs. Nevertheless, converting potential donors into actual donors is a difficult issue for many professionals. In some cases medical and surgical residents have difficulty in identifying potential donors. As well, a recent Canadian study indicated that only 35 per cent of nurses and 55.4 per cent of physicians knew how to refer organ donors.

An important issue for physicians and nurses is the difficulty and stress of discussing organ donation with family members. In the same Canadian study it was noted that 83 per cent of nurses and 75 per cent of physicians reported reluctance in approaching relatives of potential organ donors. Professional attitudes toward organ donation however are generally positive.

Co-operation from health care professionals does not require more education but rather more emphasis on the social and interpersonal issues. At the same time more efforts with regard to professional knowledge and involvement would no doubt be very helpful.

It is interesting to note that consent to organ donation among health professionals themselves does not rank much higher than among the general population. As a matter of interest, I, as a past health professional for 30 years have made the commitment to organ donation.

In 1994 a survey of physicians and nurses found that over 90 per cent of the nurses and 95 per cent of the physicians supported organ donation in principle. However only 61 per cent of the nurses and 63 per cent of physicians had completed a donor card. This compares to a 1994 public opinion survey which indicated that 58 per cent of Canadians surveyed reported having signed an organ donor card.

Further many Canadians do not discuss their personal views and intentions in this regard with their family members. This is a shame because in 1994 only 63 per cent of Canadians reported ever having discussed organ donation with a family member and 51 per cent indicated that they did not know what the wishes of their family members were with respect to organ donations. This adds to the difficulty experienced by health professionals in approaching family members and potential organ donors. Not only is it emotionally stressful to approach the subject but often family members are left in a quandary of simply not knowing whether their loved ones would want them to consent to organ donation.

Furthermore many Canadians know little about the actual process of organ donation. For example, 43 per cent still think only those in excellent health could do this. A few Canadians report fear, mistrust or uncertainty about the extraction process and 13 per cent fear AIDS or other infections. Moreover the study showed that 16 per cent of those not willing to donate expressed fear of maybe not receiving the best medical care by signing one of the cards.

Also, there may be few incentives for hospitals to become involved in organ and tissue procurement. In many provinces no funding is offered to hospitals for this procurement and hospitals must commit their own funds and resources to maintain potential donors until the organs can be recovered. The lack of financial compensation for physicians and the amount of time their involvement requires may also be further barriers.

Cultural barriers as well may be an issue here. And there may be an increasing number of important and difficult ethical issues

regarding the sanctity of the human body, including the extent to which medical technology should be used to delay death.

Thus public awareness and education while extremely important is only one dimension associated with improving organ donation in Canada. Several national and provincial governments and non-governmental organizations are already undertaking a variety of efforts to improve the level of knowledge of Canadians and of health professionals on various aspects of this issue.

Federal and provincial ministers of health are currently assessing the problems and barriers and we need to work with them. The ultimate goal of course is to promote a more concerted, collective effort in order to improve overall organ donation rates and enhance our ability to respond to the needs of Canadians.

All members of Parliament and the government have a responsibility in this. In closing I thank my hon. colleague for bringing this subject to the floor of the House of Commons. I wish it every success.

[The Deputy Speaker]

Is the House ready for the question?

[Some hon. members]

Question.

[The Deputy Speaker]

Is it the pleasure of the House to adopt the motion?

[Some hon. members]

Agreed.

[The Deputy Speaker]

I declare the motion carried. Accordingly, the bill stands referred to the Standing Committee on Health.

Motion agreed to, bill read the second time and referred to a committee.

[The Deputy Speaker]

The House stands adjourned until Monday, April 22 at 11 a.m.

(The House adjourned at 2.24 p.m.)