---

REFORM'S MINORITY OPPOSITION REPORT ON THE STATE OF ORGAN TRANSPLANTATION IN CANADA

Given the crisis in organ donation, the Standing Committee on Health was tasked to put forth a plan of action to revamp the appallingly low organ transplant rates in Canada. Many good suggestions were offered to the Committee. Unfortunately, these suggestions are buried in the Report that the Committee is putting out. Many extraneous, unnecessary issues and tasks are within the recommendations and these will detract from the immediate plan of action required and draw away limited resources from the essential, urgent solutions that must be implemented immediately. The Committee heard testimony from people who had lost children, or those who have loved ones on waiting lists. It is apparent that the failure to act wisely and effectively in the short term will result in more unnecessary deaths in our country.

In spite of the Committee member's working well together and sharing the common objective to reform our organ donor system, the Committee's Report is bogged down with bureaucratic models, and deals with issues that are not urgently required. It is unfortunate that the Committee has missed the opportunity to put forth viable solutions and an immediate plan of action. Therefore, the Reform Party's Opposition Minority Report will provide the following solutions for the Minister to take to his provincial and territorial counterparts to get an agreement that will result in a co-operative national strategy.

Recommendations:

1. That a national organ transplant coordinator be set up.

The coordinator would manage two national registries:

• A real-time national waiting list of potential recipients; and,
• A real-time national waiting list of intended donors.

All hospitals should be linked to the organ transplant coordinator through computer. There is currently a version of this model in British Columbia.

2. Mandatory reporting of all brain deaths to the national organ transplant coordinator.

This recommendation was put forth by both the Hospital for Sick Children in Toronto and representatives from the Delaware Valley Transplant Program. Through this, one could:

• determine the patient's previous intent to be a donor;
• ascertain whether the patient is medically suitable for donation; and,
• link the potential donor with the potential recipient. This would facilitate best medical match between recipient and organ donor.

3. Identify and educate existing hospital staff.

Resources should be set aside to educate some physicians, and critical care nurses who will be tasked to approach a bereaving family for their consent to donate of their loved ones' organs. There must be a decoupling of medical personnel treating the deceased patient and those approaching the surviving family members. In Spain and the United States, this dramatically improved organ donor rates.

4. We must dramatically increase opportunities to be an organ donor within our country.

Currently, the opportunities to tick off a document and become a donor are sporadic and infrequent at best. An opportunity should be presented to every adult once a year and this could happen through the doctors' offices where a form could be on every patient's chart. This form could then be given to the patient by the family physician who would then answer any questions the patient may have. The form must have three components. First, an explanation of organ donation. Second, a request to be an intended donor. Third, a request that the potential donors discuss their wishes with their loved ones. It is essential that intended donors communicate their wishes with their family. We found that, although more than 90% of Canadians support organ donation, only 52% of the time donor's wishes were respected. Forty-eight percent of the time, their wishes were overridden by their loved ones. If the intended donors communicated their wishes with their family, those wishes were respected 92% of the time.

5. A pool of funds should be available that would come from shared federal, provincial, territorial contributions. These would be targeted for organ transplantation.

In this way, tragic situations such as the man who recently could not get a double lung transplant because of a lack of funds for hospital beds would be avoided. British Columbia has a pool of funds that accomplishes this goal.

6. Recipients of organs should be able to meet the families of the donor if both parties are in agreement.

7. A medal should be awarded to the donors or their families by the Governor General. This medal would publicly recognize their outstanding contribution to life.

Given that Canada has one of the worst organ donor rates in the developed world, it is imperative that we act quickly and effectively to rectify this situation. On average, 150 Canadians die every year waiting for an organ transplant. This number is only going to increase as the incidence of people with Hepatitis C and those with diabetes escalates, thus widening the gap between available organs and people needing them.

Much of the full Committee's Report can be a work-in-progress, but the aforementioned points in this minority report must be enacted now if we are going to save Canadian lives.

We, the Members of the Reform Party of Canada, and Mr. Greg Thompson, of the Progressive Conservative Party of Canada, respectfully submit this Official Opposition Report in response to the Standing Committee on Health's Study on Organ and Tissue Donation in Canada:

Dr. Keith Martin (Esquimalt - Juan de Fuca)

Mr. Germant Grewal (Surrey Central)

Mr. Reed Elley (Nanaimo - Cowichan)

Mr. Greg Thompson (New Brunswick Southwest)