In April 2019 the Government of Nova Scotia passed the new Human Organ and Tissue Donation Act. This legislation was proclaimed on June 30, 2020 with enactment to commence Jan. 18th, 2021.
The new legislation is a first in North America and has significant positive benefits for donor families and transplant recipients in the Atlantic Provinces and throughout Canada. New changes that may impact your clinical practice include:
Nova Scotia is the first jurisdiction in North America to adopt deemed consent.
In accordance with the new legislation, all potential organ donors MUST be referred to Legacy of Life, Nova Scotia’s organ donation organization (ODO). Referral should be made at the time of suspected neurological death or prior to the withdrawal of life sustaining measures.
It is recommended that you call the Legacy of Life Program prior to discussions with families about donation.
All potential tissue donors MUST be referred to NSHA’s Regional Tissue Bank. Referral to the tissue bank can occur within 24 hours after the death of the patient.
A hallmark of Nova Scotia’s new donation legislation is deemed consent, sometimes referred to as “opt-out” or “presumed consent”.
Nova Scotians are overwhelmingly supportive of organ donation and transplantation. In a survey conducted in 2020, more than 95% of Nova Scotians expressed their support.
Deemed consent (opt out) presumes that all Nova Scotians medically eligible to donate have consented to organ and tissue donation, unless they have declared their objection through the ‘opt out’ registry or through a conversation with their families. This is a legally binding decision. At the end of life, family members of potential donors will be asked to affirm the decision of their loved ones to ensure that the expressed consent of their loved ones is respected and reflects their current decision about donation.
Exemptions to the application of deemed consent include:
With the introduction of this legislation, transplant recipients and donor families can participate in direct contact.
Transplant recipients understand the magnitude of the gift they receive through donation and often express a desire to connect with their donor’s families. Donor families often want to know how their loved ones' gifts have impacted others.
Direct contact is defined as an actual meeting between the donor family and transplant recipient, OR the exchange of information that would allow the parties to communicate directly. This only applies to transplants performed after the new legislation is in effect and when specific criteria have been met, including but not limited to a prescribed period of time following the transplant and the mutual consent of participants.