Deemed Consent In Nova Scotia’s Organ Donation Law

Do we cease to have any ownership rights on our body after our death? Or do these rights transfer to our legal heirs? Or is it the state which owns our lifeless bodies? These questions have an emotional as well as a practical narrative attached to them.  While some people believe that everyone owns posthumous rights over their bodies, others believe that the state being the rightful owner of the dead bodies can use them for organ donation or medical research.

Mostly, people decide about the treatment of their dead bodies in their lifetime. While some opt to be cremated or buried in a particular way, others choose to donate their organs for greater societal benefits. However, over the years, there has been a serious decline in organ donations worldwide. So the governments have come up with a unique solution. Simply put, everyone is a potential organ donor unless they expressly decide to opt out.

Nova Scotia’s new ‘Organ and Tissue Donation bill’ has once again sparked the debate of deemed consent for organ donation. Let’s first examine the key features of the bill:-

1. The act doesn’t apply to blood or blood constituents, semen, sperm, semen or ova. It applies to only organs and tissues.
2.  A registry is required to be maintained wherein the records of consenting, as well as dissenting individuals, shall be kept.
3. In the event, the individual does not register his/her refusal, it would be presumed that the individual has consented to transplantation after his/her death.
4. To presume consent “capacity to make a decision regarding donation is important”. People who are mentally incapacitated do not come under the purview of the bill.
5. The act applies to residents of the province and decision-makers who have the capacity to consent.
6. The physician who concludes the death of the deceased shall not participate in any transplantation procedures.
7. Once the organ donation program or tissue bank determines that an organ or tissue is medically fit for use for another person;  the deceased’s refusal, consent or presumed consent shall be cross-checked from the registry.
8. The deemed consent does not apply to donation used for scientific or educational purposes. For such a donation, express personal consent is required from the donor or the substitute decision maker.
9.  In case of a minor, a substitute decision-maker may communicate the assent/refusal of the individual.
10.  The act prohibits organ and tissue trade.
11. Any personal or donation-related information shall be only shared with medical professionals.
12. Levying heavy penalties (fine and/or imprisonment) for any voluntary contravention with the act.

Why I support the bill?

It would be wrong to say that the bill snatches away the right to body autonomy. Every resident is granted the right to make a decision regarding organ donation. Those who are mentally or physically unable to do so are not regarded as consulting adults. Moreover, donations made for scientific or educational purposes require express consent from the individual. Thus, presumed consent only applies in cases where the donation would save or improve the health of the recipient.  Further, the legislation prohibits any commercial trade of organs or tissue. It is significant that to maintain the sanctity of the transplantation the physician who examines the deceased shall not make such transplantation.

Every individual is given the right to register their refusal. Unless the consent is validated from the register no transplant can take place. It is believed that one may also conditionally refuse transplantation. Thus, in case, someone wants to just donate his/her eyes they may do so and refuse the donation of other organs. Right to body autonomy is not denied rather it is modified and everyone is asked to make an informed choice about posthumous donation. There are provisions to ensure that the privacy of such decisions is maintained thereby avoiding social ostracisation in any form.

The legislation would also help save taxpayers money. The government spends significant amounts on chronic patients, upon transplantation, these costs would decrease. Once these patients are healed they would contribute to the upliftment of the society.

This ethical legislation is need of the hour as it urges people to donate for the society. The government is taking notable steps to educate people about the provisions of organ donation. This would help people to make an informed decision about donation.

The legislation is not only about saving lives, but it is also based on the fundamental values that as a society we should stand with each other. After all, real heroes are not present in comics or movies, they are the ones who help people even after death.