P.E.I. needs programs to support organ donation, says Nova Scotia doctor

It could be a while before P.E.I. implements presumed organ and tissue donation.

Nova Scotia put its presumed consent donation policy in place back in January. P.E.I. doesn't have a similar policy right now, and before legislation is put in place the province needs proper infrastructure to support organ donation, says Dr. Stephen Beed, medical director of the Nova Scotia Organ and Tissue Donation Program.

"Infrastructure to support the identification and support of an organ donor doesn't exist in P.E.I.," he said to the legislative standing committee on health on social development Wednesday morning via Zoom.

The presumed consent legislation in Nova Scotia, the first in the country, means rather than asking people if they want to donate their organs when they die, people are asked to opt out when they don't want to donate.

Here on P.E.I., the province has an intent-to-donate registry, where you can either opt in or out of organ and tissue donation. 

Those who work with organ and tissue donation on P.E.I. have been keeping a close eye on Nova Scotia's model.

While Health PEI helps to facilitate organ donation, Dr. Beed said there needs to be a more robust program to support the idea of organ donation before legislation is put in place.

"The starting point for P.E.I. should not be a new law. It should be investment in those sort of basics," he said, adding a donation program would require a medical director and some nursing staff.

"If establishing those basics includes a conversation around what the consent model in the province might be then fair enough, you might go there — but without those other things in place a granular conversation around the consent model isn't going to get you anywhere."

Beed said P.E.I. needs to set up an organ donation program with an accountability structure, administrative support, nursing staff and a medical director.

According to the Health PEI website for organ and tissue donation, "to become an organ donor, you must die in hospital while on life support, and have an irreversible brain injury. If you meet these criteria, you will be referred to the Organ Donor Coordinator in Halifax."

"You have clinicians who don't have specific interest in organ donation or knowledge about the process except for the general sense," he said. "The issues around organ donation are somewhat unique and there is no one in P.E.I. who has sort of committed to that."

Beed said in 2020 when work was being done for legislation to come into effect in Nova Scotia there "was a huge increase in donor activity."

Beed said the challenge is creating an ongoing discussion to maintain organ and tissue donations.

"The early signaling we are getting is positive, that positive change is going to come. Time will tell how significant it is going to change," Beed told CBC News: Compass host Brittany Spencer.

However, there are still more organs needed than there are donors in Atlantic Canada.

"There is a huge need and that need isn't going away in the near future, but we are going to try to narrow the gap."

The biggest challenge we found in Nova Scotia, and I have to assume would be the case in Prince Edward Island, is that potential donors are not even being identified on the front end.— Dr. Stephen Beed

The Island has sent nine donors to Nova Scotia in the last five years, over that same time frame 43 Islanders got organ donations, Beed said.

"The biggest challenge we found in Nova Scotia, and I have to assume would be the case in Prince Edward Island, is that potential donors are not even being identified on the front end. The patient with a huge stroke in a smaller emergency department isn't recognized by the team. They could be a donor, for example, so those phone calls don't get made," he said.

"That happened in Nova Scotia. I am assuming that is definitely happening in Prince Edward Island."

A program to support education around organ and tissue donation for healthcare staff is a good first step, he said.

Since presumed consent in Nova Scotia came into effect only about three per cent of people opted out of the program, Beed said.