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Created August 11, 2014 13:08
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From: <>
Subject: RE: TGLN Inquiry: Comment on Presumed Consent
Date: July 31, 2012 at 1:06:42 PM EDT
Cc: <>
Dear Mr. Paul Schreiber:
Thank you for writing to Trillium Gift of Life Network, and for your comments on presumed consent.
Ontario continues to use the “opt-in” system (rather than presumed consent, or the opt-out system) because the people of Ontario do not currently support the implementation of presumed consent. When the Citizens’ Panel toured Ontario in 2007 and raised this issue with the public in towns and cities across the province, the public was evenly split on the issue, with the edge going to those who opposed presumed consent. As well, neither the Ontario Medical Association nor the Canadian Medical Association has spoken in favour of presumed consent.
When Trillium Gift of Life Network’s (TGLN) board of directors studied the issue, they surveyed the practices in 25 countries that use presumed consent, and they found that, with a single exception (Austria), physicians always double-check with families before taking an organ from a deceased relative (even in Spain).
Instead of presumed consent, Trillium Gift of Life Network has implemented Routine Notification and Request, which requires hospitals to inform Trillium Gift of Life Network of imminent deaths, so that TGLN coordinators can talk to the families of the deceased and affirm the patient’s wish to be an organ and tissue donor. In addition, we are encouraging people to register their consent to donate (either online or through filling out the Gift of Life Consent Form and mailing it to Service Ontario), so that support for donation is recorded securely in a Ministry of Health and Long-Term Care database and made known to the family at the time of a patient’s death. It is far more likely for families to give consent to organ and tissue donation if the patient has registered his/her consent.
In key hospitals across the province of Ontario, Trillium Gift of Life Network has placed Organ and Tissue Donation Coordinators to work with the doctors and the medical staff to facilitate the process and ensure a successful organ and tissue recovery surgery. All hospitals in Ontario can call Trillium Gift of Life Network to make a referral; we support donation in any hospital in Ontario. We are currently in the process of expanding required reporting (Routine Notification) to more hospitals with critical care units, and this process will help us screen for potential for organ donation in those centres who have the highest potential for organ donation.
In an end-of-life situation, when nothing more can be done to save a patient’s life – and only if there is no hope for that patient’s recovery – the hospital will then inform Trillium Gift of Life Network of that person’s imminent/impending death. Then, a TGLN employee from the Provincial Call Centre will call the Service Ontario “OHIP” call centre and provide the patient’s health card number, and receive confirmation of that patient’s status as a donor. Written confirmation of your wishes will be given in strictest confidence to our Organ and Tissue Donation Co-ordinator, to be shared with your loved ones for the purpose of ensuring that the decision to donate is known and respected.
When a person registers his/her consent to donate, he/she ensures that the decision is recorded and can be made available to loved ones when needed. All families of potential donors, whether registered or not, are approached when TGLN receives the routine notification at end of life, and when discussions about the desires of the potential donor take place. Registration of one’s decision makes this discussion easier on families, and expedites the process. That’s why we are now encouraging people to register their consent to donate.
Again, thank you for writing to Trillium Gift of Life Network, and for your thoughtful comments – and thank you for supporting organ and tissue donation.
Trillium Gift of Life Network
Register today at
One donor can save up to eight lives and improve life for up to 75 others.
522 University Avenue
Suite 900
Toronto, ON M5W 1W7
Tel: 416.363.4001 or 1-800-263-2833
Fax: 416.363.4002
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