CHAPTER 6
CONCLUSION

Canada is currently facing a serious situation with respect to organ and tissue donation and transplantation. In contrast to a commendable transplantation reputation, extremely low donor numbers have resulted in ever-expanding waiting lists. Donors are being denied opportunities to donate while potential recipients are dying.

The Committee is sensitive to the complexity of the donation/transplantation continuum. It is aware of the multiple levels of responsibility shared among federal, provincial and territorial governments, national and regional organizations, individual hospitals (and other healthcare facilities), individual professionals and the public at large. Each plays a significant role in optimizing the organ and tissue donation and transplantation process. However, the current system has been described as fragmented and piecemeal, one clearly in need of a coordinated national approach. This is the framework that the Committee has delineated in this report; one that integrates all the players and all the pieces but supports the need for a multi-pronged solution.

The first area of concern, that of donor intent, can most productively be addressed through education and this is an area in which the federal government can play a part working alongside the many existing groups. A properly executed awareness or education campaign will then leave the onus on individual Canadians to consider the issue, make a decision with respect to intent, and voice the intention to loved ones.

To the Committee, it is the second stage of the continuum, donor identification, management, and procurement, where the most significant effect can be made on increasing donor numbers. A commitment to increase the identification and ultimate procurement of donors at the critical care or intensive care facility will expand responsibility for the provinces, regions, hospitals, OPOs and individual professionals.

Within the context of waiting, sharing, matching and allocation, the Committee envisioned some level of national responsibility due to the accessibility and interprovincial aspects. The Committee also believes that involvement of professional organizations in consultation with voluntary organizations is essential for establishing and maintaining waiting lists and allocation algorithms. This is one area where national oversight could ensure greater compliance.

The final stage of the continuum, transplantation, involves the provinces, hospitals, and healthcare professionals. Nationally, the Committee feels that there is a role to be played with respect to data collection and education. Federally, there is a role in the enforcement of standards under the Canada Health Act and the Food and Drugs Act.

In undertaking this study, the Committee resolved to seek a solution that could result in immediate action while ensuring continuing and cohesive efforts. In supporting a national framework to address the numerous donation and transplantation needs, it hopes that all Canadians will benefit.