Skip to main content
The Globe and Mail
Support Quality Journalism.
The Globe and Mail
First Access to Latest
Investment News
Collection of curated
e-books and guides
Inform your decisions via
Globe Investor Tools
per week
for first 24 weeks

Enjoy unlimited digital access
Enjoy Unlimited Digital Access
Get full access to
Just $1.99 per week for the first 24 weeks
Just $1.99 per week for the first 24 weeks
var select={root:".js-sub-pencil",control:".js-sub-pencil-control",open:"o-sub-pencil--open",closed:"o-sub-pencil--closed"},dom={},allowExpand=!0;function pencilInit(o){var e=arguments.length>1&&void 0!==arguments[1]&&arguments[1];select.root=o,dom.root=document.querySelector(select.root),dom.root&&(dom.control=document.querySelector(select.control),dom.control.addEventListener("click",onToggleClicked),setPanelState(e),window.addEventListener("scroll",onWindowScroll),dom.root.removeAttribute("hidden"))}function isPanelOpen(){return dom.root.classList.contains(}function setPanelState(o){dom.root.classList[o?"add":"remove"](,dom.root.classList[o?"remove":"add"](select.closed),dom.control.setAttribute("aria-expanded",o)}function onToggleClicked(){var l=!isPanelOpen();setPanelState(l)}function onWindowScroll(){window.requestAnimationFrame(function() {var l=isPanelOpen(),n=0===(document.body.scrollTop||document.documentElement.scrollTop);n||l||!allowExpand?n&&l&&(allowExpand=!0,setPanelState(!1)):(allowExpand=!1,setPanelState(!0))});}pencilInit(".js-sub-pencil",!1); // via darwin-bg var slideIndex = 0; carousel(); function carousel() { var i; var x = document.getElementsByClassName("subs_valueprop"); for (i = 0; i < x.length; i++) { x[i].style.display = "none"; } slideIndex++; if (slideIndex> x.length) { slideIndex = 1; } x[slideIndex - 1].style.display = "block"; setTimeout(carousel, 2500); } //

Dr. Stephen Beed, medical director of Nova Scotia's organ and tissue donation program, at the Halifax Infirmary, on Jan. 14, 2021.

Andrew Vaughan/The Canadian Press

Nova Scotia is now the first jurisdiction in North America to implement presumed consent around organ donation, a move health officials believe could see a significant rise in the number of donors over the next few years.

Legislation passed in April, 2019, finally took effect Monday after more than 18 months of work to ensure provincial systems were equipped to handle the change.

Under the Human Organ and Tissue Donation Act, all people in Nova Scotia will be considered potential organ donors unless they opt out.

Story continues below advertisement

“To my knowledge, nobody else is close to considering this, but many places are thinking about it,” said Dr. Stephen Beed, medical director of Nova Scotia’s organ and tissue donation program. “We have an opportunity to transform a component of the health care system and that just does not happen very often.”

In an interview last week, Dr. Beed said the work to bolster the province’s organ donation program has focused on planning, education and public awareness.

He said the system has, in effect, been “rebooted” with the recruitment of several donation physicians and an increase to the number of system co-ordinators, who have also seen a change in their training. Over all, 27 new professionals have been brought into the system over the past three years.

In addition, a donation data system has been developed to assess the program’s performance. The province plans to spend $3.2-million this fiscal year to bolster the system.

“Over all I honestly think that the system change is the most important part,” Dr. Beed said of the shift to presumed consent.

He said that was the message delivered to Premier Stephen McNeil when he first approached health officials with the idea for the legislation.

“We said, ‘If you change the law all you really have is words on a piece of paper, but if you change the law and then support the redesign of our system then you have reason to be optimistic.’”

Story continues below advertisement

Dr. Beed said organ donation rates increased by as much as 35 per cent in European countries such as Belgium and Spain after they adopted an opt-out system, although he pointed out other jurisdictions that made the switch have had the opposite experience.

But one prospective organ recipient said the success stories abroad have left her more optimistic about matters closer to home.

“I am very proud that Nova Scotia is the trailblazer for this,” said Anita MacDonnell of Halifax, who is awaiting a kidney transplant.

“I was very encouraged when they announced this back in 2019.”

Ms. MacDonnell, who turns 60 on Wednesday, was approved for a new kidney last May and started dialysis in October.

She and her friend Brenda Mackenzie, also of Halifax, suffer from a genetic kidney disease that has seen several of their siblings and both of their mothers require transplants in the past.

Story continues below advertisement

Both women undergo dialysis three nights a week for four hours at a time and liken the life-saving process to having a part-time job.

Ms. Mackenzie, 60, describes her wait for a kidney as “pretty nerve-racking.”

“So I guess my hope obviously would be that with this [change] that so many more people would be able to be transplanted,” she said. “That’s what the ultimate hope is.”

The new approach hasn’t received universal support on its way to becoming provincial law.

Some civil libertarians balked at the legislation when it was first proposed, raising concerns around governments having the power to tell people what to do with their bodies. Other opponents expressed potential cultural and religious concerns about the move.

Dr. Beed said he believes those issues have been addressed through the development of an opt-out registry and safeguards such as double checking with families to ensure the last known wishes of a potential donor are honoured. Those who tell their families that they don’t want to be donors will see those instructions respected, he said, even if they haven’t formally opted out.

Story continues below advertisement

In addition, certain groups will be exempt such as new immigrants, transient residents of Nova Scotia and people who don’t have capacity to make their own decisions. Dr. Beed said talks are also continuing with leaders of religious and faith communities to ensure they are “engaged” with the system.

Peggy John, the acting director for the organ and tissue donation and transplantation program at Canadian Blood Services, agrees the opt-out program will only be as good as the strength of the system put in place to support it.

Ms. John, whose organization is the national collaborating body for provincial transplant systems, said the end goal should be to increase the opportunities for transplant for patients who are in need.

According to the most recent figures compiled by Canadian Blood Services, 250 Canadians died while waiting for a transplant in 2019 – an increase from 223 in 2018. They also showed Canada still has a shortage of organs, with 4,419 patients still waiting for transplants at the end of 2019.

Ms. John said the new Nova Scotia law will be an opportunity to observe and to learn about what might work elsewhere to potentially boost donation rates.

“We are keen to see what’s going to happen,” she said. “We know they [Nova Scotia] have been approaching this in the right way and we will continue to watch what the outcome will be.”

Story continues below advertisement

Our Morning Update and Evening Update newsletters are written by Globe editors, giving you a concise summary of the day’s most important headlines. Sign up today.

Your Globe

Build your personal news feed

  1. Follow topics and authors relevant to your reading interests.
  2. Check your Following feed daily, and never miss an article. Access your Following feed from your account menu at the top right corner of every page.

Follow topics related to this article:

View more suggestions in Following Read more about following topics and authors
Report an error
Due to technical reasons, we have temporarily removed commenting from our articles. We hope to have this fixed soon. Thank you for your patience. If you are looking to give feedback on our new site, please send it along to If you want to write a letter to the editor, please forward to

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff. Non-subscribers can read and sort comments but will not be able to engage with them in any way. Click here to subscribe.

If you would like to write a letter to the editor, please forward it to Readers can also interact with The Globe on Facebook and Twitter .

Welcome to The Globe and Mail’s comment community. This is a space where subscribers can engage with each other and Globe staff.

We aim to create a safe and valuable space for discussion and debate. That means:

  • Treat others as you wish to be treated
  • Criticize ideas, not people
  • Stay on topic
  • Avoid the use of toxic and offensive language
  • Flag bad behaviour

If you do not see your comment posted immediately, it is being reviewed by the moderation team and may appear shortly, generally within an hour.

We aim to have all comments reviewed in a timely manner.

Comments that violate our community guidelines will not be posted.

Read our community guidelines here

Discussion loading ...

To view this site properly, enable cookies in your browser. Read our privacy policy to learn more.
How to enable cookies