Madam Chair, I am very pleased to be able to speak today on the crucial importance of organ donation.
Donating one’s organs or tissues means giving the gift of life to someone who truly needs it. Obviously, consenting to donate one’s organs is not an easy decision and a number of factors may also influence that choice. In any event, more and more people are dying while still waiting for an organ to be offered by a generous person. The gap between the number of organs available and the number of patients waiting continues to grow. The number of people desperately waiting for the telephone call that will change their life is also growing steadily. It is therefore important for us to discuss this, to think about it and to develop strategies that will improve the situation.
In spite of recent efforts to increase the number of organ donations, the number of organs available in Canada has stagnated. The two reports published in 1999, one produced by the House of Commons Standing Committee on Health and the other by the National Coordinating Committee for Donation, led to only meagre progress and did not result in the adoption of a long-term, Canada-wide strategy orchestrated by the provinces and the federal government.
Canada is still far behind other countries such as Spain, France and the United States in terms of the number of post mortem organ donations. In fact, Spain’s rate of post mortem donors is twice as high as Canada’s. Of course, that figure depends on a number of other factors, including the traffic accident rate, for example.
According to statistics from Transplant Québec, a provincial organ donation agency, the number of organ donors fell from 151 to 119 between 2008 and 2010, while the number of people needing transplants rose from 1,159 to 1,241 in the same period. The trend is therefore very similar in Canada. We need to redouble our efforts if we want to be able to close that gap.
There are solutions to consider, however. On average, each donor contributed to nearly four lives, and a single donor can save as many as eight lives. Saving lives is therefore within the reach of all of us. So what can we do to increase the number of patients who receive an organ donation?
Because health is under provincial jurisdiction, the federal government can play a coordinating role in raising awareness and in initiating a dialogue with the provinces to establish a national organ donor registry and possibly adopt measures that have been successful elsewhere. We should also consider creating a more effective registry of recipients and way of searching for matches between the two registries. Establishing a national registry would therefore facilitate the process of identifying people who need a donation or people who are prepared to donate. The registry could be associated with income tax returns or the census form. Then everyone who worked on their finances at some point during the year would have to think about the importance of organ donation.
There is not always a lot of leeway in terms of time when an organ transplant is needed. The less time people have to wait, the greater the chances of success. Information is needed before a transplant is done, such as blood group, tissue type, the size of the organ, the urgency of the procedure, and so on. A national registry that was managed effectively could mean a higher success rate.
Let us talk about awareness building. There have been no further campaigns since the 2001 and 2002 national campaigns, which followed the recommendations from the two 1999 reports. The focus should instead be on a long-term awareness-building strategy in order to ensure, among other things, that health care professionals can discuss these matters with their patients and that families discuss organ donation more. Moreover, according to the doctors I consulted, families can sometimes be an obstacle to organ donation following the death of a loved one.
We know that doctors do not necessarily have the resources or the time required to make requests of the families of the deceased. More money should therefore be invested to give doctors the tools they need and to help health care professionals obtain family consent in order to proceed with the removal of organs from a deceased person.
This certainly is not the best topic of conversation around the dinner table at holiday time, but it is an important subject to discuss with our loved ones. If, upon reflection, you consent to donate your organs and tissue upon your death, it is crucial that you share your decision with your loved ones, which may also have a positive effect in terms of how others think.
Building awareness is important as it helps to debunk myths and address public fear. For example, many people are afraid that if they give prior consent, less effort will be put into saving their lives. In fact, this fear may explain the discrepancy between the number of people who are in favour of donation and the number who actually sign their donor card. In fact, this discrepancy may also be due to simple logistics, but if doctors were able to discuss this myth, people would be reassured and might be more likely to sign their donor card and discuss what they have done more openly.
Moreover, we could also encourage our provincial counterparts to explore the question of presumed consent. Canada currently uses a system based on explicit consent. In other words, consent cannot be presumed given unless the individual in question has signed an official statement indicating his or her consent.
In some countries, such as Spain, where the post-mortem donation rate is very high, consent is presumed, which means that it is assumed that the individual automatically agrees to donate his or her organs upon death, unless the person, while alive, has expressly refused organ donation. Those in favour of presumed consent argue that, according to polls, the majority of Canadians are in favour of organ donation, but very few of them complete their donor card. In short, although I am not explicitly suggesting that we should adopt this kind of approach, it is nevertheless worth serious and in-depth consideration.
Finally, the Health Canada standards for potential donors could be revised. Currently, these standards exclude homosexual men, because men who have had sexual relations with other men in the last five years are excluded. This is an outdated standard because we now have the tools required to screen for blood and organ diseases. There is a lack of dialogue in the medical and research community concerning Health Canada's standards.
In light of the growing gap between the number of available organs and the number of people in need of an organ, we must act very quickly. We will have to be creative and work closely together with the provinces and territories. There are enough examples elsewhere for Canada to find practical and achievable solutions. Canada must develop a public awareness campaign to facilitate and encourage organ donation, explain how the organ donation process works, and do more to create a national registry of donors and recipients.