Back in February, the Planet Money podcast had an episode about organ donation.
I think most of it would be familiar to anyone who follows the issue, but one thing was new to me. I have often heard that an easy way to increase the number of organ donors is to switch from an opt-in system for participation to an opt-out system. Nobody is forced to be a donor, but it becomes the default option.
The episode identified a problem with this, at least in the United States, in that medical teams may not interpret this as adequate consent to donate and may then ask family members for more information. People who have not made a conscious choice may not advise family about their intentions, and so organs that might otherwise be transplanted go to waste.
For the record, I am signed up to be every kind of donor you can be in Ontario (with a “DONOR 9Z” on the back of my health card). Back when I still bicycled in cities, I also wore a green organ donor ribbon on my main cycling backpack, for the benefit of any paramedics.
For several years now, I have been wanting to complete a living will or advance directive, but I haven’t gotten around to finding a lawyer who can take me through it.
I took a course and wrote a living will several years ago. It is a good thing to go through and plan, especially when a person gets older.
A living will is only an expression of wishes. It is not legally enforceable. For that you need a Representation Agreement in which you appoint a representative to speak for you when you are incapacitated including the right to consent to or refuse treatment on your behalf. Neither has anything to do with organ donation.
There seem to be a fair number of similarities to me: expressing your desire for how doctors should deal with your body, providing clear guidance to your family, etc. Both also require some legal knowledge, with rules varying between jurisdictions.
The problem is when doctors decide they do not agree with your wishes and decide you are to be kept alive artificially even when you said you didn’t want that. If you have a representation agreement, it can be enforced by a court. The living will cannot.
Majority of Canadians eligible to donate organs don’t, study finds
An estimated two-thirds of deceased patients who are medically eligible to donate organs in Canada don’t — even if that was their wish, a new report has revealed.
The Canadian Institute for Health Information (CIHI) looked at more than 100,000 hospital deaths per year between 2008 and 2012.
The rate of organ donation among eligible donors varies by province. Quebecers are the biggest organ donors at 21%, more than double that of Saskatchewan and Manitoba at 10%.
“Organ donation is a complex process, which involves identifying potential donors, getting consent from the families and procuring the organs around the time of death,” said Kathleen Morris, director of Health System Analysis and Emerging Issues at CIHI in a news release Thursday. “While it may not be possible to convert every potential donor (to an actual donor), the data suggests that Canada can go further in improving the health or saving the lives of Canadians waiting for organ transplantation.”