http://www.theguardian.pe.ca/Opinion/Columns/2012-10-06/article-3093496/Making-organ-donation-the-default-position/1Making organ donation the default position
Rick MacLean
P.E.I. is thinking about changing the way it approaches organ donation. It should.
Right now, Islanders are like the rest of Canada. They must opt-in if they want to donate their organs. They must choose to take part.
It's a system that doesn't work very well. What does work, and what the province is considering, is called opt-out.
It's simple enough. Organs of any deceased Prince Edward Islander that might be suitable for transplant would be considered available for transplant, unless the person said no while alive, filling out a form to indicate their opposition.
Opt-out works. Brilliantly.
The idea received a nudge recently when the results of a recent poll suggested there's public support for opt-out. Corporate Research Associates found 55 per cent of New Brunswickers - and 60 per cent of Nova Scotians - back opt-out over opt-in. The number is 56 per cent in Newfoundland and Labrador.
Those numbers caught the attention of Dr. Richard Wedge, the acting CEO of Health P.E.I., who likes the idea of moving towards opt-out.
It's the right idea for a bunch of reasons, including the desperate need to increase the number of organs available for transplant. Recent numbers under the opt-in system are distressing.
"Living and deceased donor rates have stagnated since 2006," said the Canadian Institute for Health Information in a report released earlier this year.
Two years ago, there were just 16.3 people out of every million willing to donate, the institute said. That was down from 17.0 four years earlier. The number is also falling in the case of donations from those who have died. It was 13.6 per million two years ago. That's down from 14.0 four years earlier.
"The gap between donations and the need for transplants is growing," the institute said.
It means people are dying, people who could live, the institute suggested.
"During 2010, 229 patients died while waiting for organs. The end of the year saw 501 patients waiting for a liver, 135 for a heart, 310 for a lung and 98 for a pancreas. The vast majority of people waiting - 3,362 patients - needed a kidney."
That's brutal arithmetic - 4,406 people on the waiting list at the end of the year. And hundreds of them died because they couldn't get the help they needed.
The problem is the opt-in system, which is notorious for producing low rates of donors.
Why? Because people tend to simply go along with what is known as the default position when it comes to making such decisions. We lead busy lives. So we don't spend a lot of our precious time pondering decisions that don't really affect us right now.
It's the same reason so many people use 1-2-3-4 as their password online, even though it's a dumb idea. It's the default code. Who has time to figure out how to change it?
But nations using an opt-out organ donation system have much higher numbers of people willing to help others. Are they more generous than we are? No. They're simply picking the default position, which is to donate.
Opt-out doesn't prevent anyone with strong feelings on the issue from getting what they want. Don't want to donate their organs? No problem. Fill out a form - make it online to make it easier - and you've opted out. End of discussion.
But if you don't have strong feelings on the matter, you simply leave the default position in place and, if the time arrives when your organs might be able to help someone else, they're available.
What's the big deal?
Well, 195 people died waiting for a donor last year, according to the Canadian Society of Transplantation. And there are about 260 people are on the transplant list in Atlantic Canada.
It's a very big deal to them.
Rick MacLean is an instructor in the journalism program at Holland College in Charlottetown.