The following statements reflect the Foundation's position on a variety of issues pertaining to organ donation. They serve to support our advocacy work to ensure that health practices and policies are in place that will optimize organ donation in Canada.
Leadership, Coordination and Funding
The Kidney Foundation calls upon the Federal/Provincial/Territorial Conference of Deputy Ministers of Health to develop and implement a comprehensive, coordinated and sustainable national strategy concerning organ donation in collaboration with a broad range of stakeholders including government, health care, and the public and voluntary sector. The objective of such a strategy would be to ensure leadership, coordination and funding in the following areas:
- National Practice Standards/Guidelines regarding donor identification, evaluation, referral, request, organ recovery and distribution
- A fully integrated, National Data Management System to support and monitor compliance with the (proposed) national standards and guidelines
- Organ donation programs, integrated into hospital structures
- Professional Education
- Public Education
The Kidney Foundation of Canada promotes activities which increase awareness of the importance of organ donation, encourages people to communicate their intent as an organ donor and discuss their wishes with their families.
First Person Consent
The Kidney Foundation of Canada supports upholding the individual’s right to make known his/her decision regarding organ and tissue donation and to have it carried out at the time of death.
Intent to Donate
The Kidney Foundation of Canada is in support of effective mechanisms that record, in advance, consent to donate organs and tissues at the time of death.
In situations where there is no advance communication of intent to donate, The Kidney Foundation of Canada supports proxy consent, whereby the proxy decision maker will be approached for consent before removal of a donor organ.
Donation after Cardiac Death (DCD)
The Kidney Foundation of Canada is in support of organ donation after cardiocirculatory death (DCD), in controlled settings where an unhurried consent discussion can be held, and recommends that hospitals develop the required internal policies and procedures based on the national recommendations of the Canadian Council for Donation and Transplantation.
The Kidney Foundation of Canada supports living organ donation. Organ transplantation from a live organ donor is an ethically acceptable practice providing the person who gives consent to be a live organ donor is competent to make the decision to donate, willing to donate, free from coercion, medically and psychosocially suitable, fully informed of the risks and benefits as a donor, and fully informed of the risks, benefits, and treatment options available to the recipient.
Live Donor Database
The Kidney Foundation of Canada supports expansion of the Canadian Organ Replacement Register (CORR) to include tracking of demographic, clinical, and outcome information on all live kidney donors.
Financial Barriers to Live Donation
As live organ donation is a voluntary act of giving, The Kidney Foundation of Canada supports the principle that live organ donors should not personally bear any costs associated with donation.
Commercial Trade of Human Organs
The Kidney Foundation of Canada condemns the practice of buying and selling organs for transplantation. The Kidney Foundation does not support:
- Economic incentives to individuals to donate an organ for transplantation. (However, this does not preclude the reimbursement of reasonable expenses incurred by a donor during the donation process).
- Advertisement of organs for sale.
- Brokering the movement of organs, donors, recipients or transplant professionals for the purpose of organ trafficking, transplant commercialism or transplant tourism, as defined in the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, 2008.
- Use of organs suspected to have been obtained through commercial transaction.
Organ trafficking is the recruitment, transport, transfer, harboring or receipt of living or deceased persons or their organs by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving to, or the receiving by, a third party of payments or benefits to achieve the transfer of control over the potential donor, for the purpose of exploitation by the removal of organs for transplantation.
Transplant commercialism is a policy or practice in which an organ is treated as a commodity, including by being bought or sold or used for material gain.
Transplant tourism is travel for the purpose of organ trafficking and/or transplant commercialism or when the resources (organs, professionals and transplant centers) devoted to providing transplants to patients from outside a country undermine the country’s ability to provide transplant services for its own population.
Individual Appeals to the Public for Living Organ Donors
Insofar as individual appeals to the public for living donors may increase the number of kidneys available for transplantation, The Kidney Foundation of Canada is in support of appeals that enable potential organ donors and recipients to connect for the purpose of living organ donation.
The role of the health care team is essential in determining suitability of the living donor/recipient match and the Foundation supports the use of rigorous evaluation protocols to ensure protection of both the living donor and transplant recipient.
The connection between the potential donor and transplant recipient must not include an economic incentive to the living organ donor. (see Living Donation, Commercial Trade of Human Organ)
The Kidney Foundation does not recommend that Canada proceed with xenotransplantation involving humans at this time as there are critical issues related to safety and efficacy that first need to be resolved. Health Canada must continue to inform and involve the public in discussions about the future of xenotransplantation. Before clinical trials are permitted in Canada, stringent and transparent legislation and regulations must be developed. The Kidney Foundation encourages further research at the pre-clinical level in order to gain further knowledge about the potential health risks and viability of xenotransplantation. Alternatives to xenotransplantation should be further explored.