Nova Scotia’s Presumed Consent Law: What does this mean for Ophthalmology?

Nova Scotia recently made one of the most significant Canadian health policy changes in recent memory. Normally, we consent, or “opt-in” to organ donation by stating that yes, we do want to be an organ donor. If no explicit directive is given, it’s assumed that we are not organ donors. Nova Scotia has flipped the switch; now, there is an “opt-out” system, meaning that if you do not give any explicit directive, you are automatically an organ donor. So what does this mean for eye care in Nova Scotia?

Image: https://www.halifaxtoday.ca/local-news/nova-scotia-sets-new-record-high-for-organ-donors-in-2020-3170698

Previously, Nova Scotia had implemented the Multi-Organ Transplant Program, which had increased donations. But it was not enough. 8 in 10 Nova Scotians still could not receive life-changing organ donations. This law seeks to change that. “This legislation will allow for more Nova Scotians to receive life saving organ or tissue transplants and is a positive and true transformational change in health care in Nova Scotia,” says Dr. Stephen Beed, medical director of the Nova Scotia Organ and Tissue Donation Program

So far, about 1% of the population have opted out. This means that 99% of the population (for now, keeping in mind this policy is new) are organ donors. This has massive implications for health and eyecare, as we should see a surge of new donations; more and more people will have access to life altering organ procedures. Specifically, more corneas can be donated. These cornea donations are life-altering. As a result of this new policy, more Nova Scotians will be able to restore their eyesight with over 95% of corneal donations restoring vision.

However, this law is not without its controversy. Opt-out consent models are relatively new, and blur the lines ethically. Many argue that this form of “presumed consent” is not ethical, as marginalized groups and peoples who may not be aware of this law may end up as donors against their will. Nova Scotia has attempted to combat this as persons under 18, without decision making capacity, and newcomers (lived in Nova Scotia for under a year) are exempt.

Though this change is controversial, it provides a bright future for those who need corneal transplants in Nova Scotia. If this law were to be implemented across Canada, we may significantly reduce the demand for transplants, and increase vision quality for many.

Sources:

https://novascotia.ca/organ-and-tissue-donation-changes/

https://www.cbc.ca/news/canada/nova-scotia/opt-out-organ-tissue-donation-program-1.5890385

https://atlantic.ctvnews.ca/nova-scotia-organ-donation-presumed-consent-law-takes-effect-1.5271098