Organ Shortage and the Need for Organ Donation in Canada

At only 57-years-old Ontario resident Matin Khan was left to fight excruciating pain as she slowly became paralyzed, following her mission to find a kidney in Pakistan, which quickly went wrong. After she returned to Canada, the donated organ became infected and swollen, causing fluid to push against her spine, resulting in paralysis. After weekly dialysis treatments and being told seven years later, “you may not be able to get a kidney,' she felt transplant tourism was her “last chance at life” (Priest, 2003, para. 6-9). Khans actions exhibit simply how desperate Canadians are becoming. The severe need for organ donations is prominent now more than ever. Just one, donor could save up to eight lives, and be able to benefit over 75 people, yet hundreds of Canadians still decide to ignore the organ donation form. (Kindy, Bernstein, & Keating, 2018, para. 12). Most Canadians recycle plastic so what's the problem with recycling organs? If the government of Canada was to propose a financial incentive
for donating organs, persistent evidence indicates waiting lists would diminish and more Canadians would become donors.

The Trillium Gift of Life, network is a website that aims to inform the public about organ donations. The website entails statistics and success rates, how to donate, and the major need for organ donation in Canada. In Canada alone, as of April 3, 2019, there are over 1,600 people currently waiting for organs. From January 1, 2019, to March 31, 2019, only 275 surgeries have occurred (Trillium Gift of Life, n.d., “Statistics: Transplantation,” para. 5). The imbalance of supply and demand forces many vulnerable Canadians to travel to foreign countries to buy and receive organs to participate in transplant tourism. While sometimes this may help, many people become even more sick whilst travelling for organs. Transplant tourism describes an individual travelling to some of the poorest countries in the world to receive an organ from someone willing to sell one to pay off debts, or to simply live a financially comfortable life. On average 20 people die each day waiting for a transplant while the waiting list lengthens. 85% of Canadians allegedly support organ donation, meanwhile, only 33% of Canadians have made plans to donate. (Trillium Gift of Life, n.d., “Organ and tissue donation saves lives,” para. 3). Even if many Canadians had plans to donate, the circumstances through which a cadaveric (deceased) organ can be donated are under strict guidelines. This results in many potential donors not being able to donate due to the way they die. Cadaveric organ donors are generally brain dead, and must have all major organs still functioning so as to donate. Many live organ donors have been young adults involved in a serious accident causing severe brain injury (Statistics Canada, 2010, para 12). People are getting older, and this issue is not improving, the need for organs is continually increasing. Unfortunately, there are a number of reasons why a person cannot or may choose not to donate. Some of which include religion, consent may not be obtained in time, mistrust of doctors, and most commonly, not knowing enough about the issue. The government of Nova Scotia has just recently proposed an opt-out rule. This would make all adults in the province potential organ donors, unless they specify on an opt out card mailed out with drivers licenses. Due to technological advances constantly improving, the life expectancy in Canada is rapidly increasing. As our population ages the need of organs is on the rise.

The idea of incentives for organ donation has been a topic of interest for a number of years. The province of British Columbia has adopted an “Organ Donation Expense Reimbursement Program” (LODERP), to increase their potential donor list. Some of these incentives include reimbursement in travel, accommodations, meals, and post operation expenses. Instead of sitting back and watching other provinces act upon this issue, Ontario should take action and introduce incentives such as a reduction in income taxes, a donor metal of honour, reimbursement for funeral expenses, or even creating donor insurance, which may include life and disability insurance. There are many arguments regarding the moral and ethical dilemmas over offering incentives for organ donation. An argument made by Auburn university economic professor, Andrew Barnett, describes that by offering incentives to those who decide to donate, we replace the term “donor” with “vendor”. (Delmonico et al, 2002, p. 2003). Because organ donation is voluntary and often considered a “charitable gift”, this implies that those willing to donate for incentives aren’t donating for the other person, but for themselves. The Red Cross provides T-shirts, food, and drinks to those who donate blood so why can't organ donation organizations offer incentives as well?

As a result of the organ shortages in Canada, many desperate people are willing to travel to foreign countries to buy organs for thousands of dollars, in hopes it’ll save their lives. After hearing he could wait up to 12 years for a kidney, Toronto, Ontario resident Raul Fain, decided he would travel to Kosovo to buy and receive a kidney for an overwhelming $105,000. After Fain returned to Canada he became a witness in a lengthy trial, regarding involvement with the international organ-trafficking network. Many women were promised up to $20,000, for donating one kidney. None of them were ever paid. (Qena & Sher, 2012, para. 1-12). This specific case displays the potential exploitation and unreliability placed upon those willing to participate. A few Canadians travelling for organs have any relationship at all with the donor, before or after the procedure. The contrast between who is traveling for the organ and who is donating is drastic. Those donating usually come from third world countries, or are in desperate need of financial aid. There are many instances of transplant tourism as well as black market organ donation. Neither of which are appropriately monitored or 100% safe.

The price of organs being sold through the black market and transplant tourism is increasingly expensive as make shift surgeons gain profit. According to the Journal of Public health, organs being sold on the black market range in price, depending on the organ, anywhere from $21,000 to $200,000. The annual price in Canada, for kidney dialysis is $60,000 per person. Meanwhile, a kidney on the black market generally costs 23,000 (Advisory Board, 2012, “Illegal kidneys can sell for,” para. 5). This illustrates that it is usually cheaper and more time efficient for the individual needing an organ to travel abroad to purchase a kidney, rather than going through lengthy weekly dialysis treatments.

It is no surprise that the organ shortage in Canada, is not improving. As a society, the government, and law makers of Canada need to take control of this issue. Incentives for people willing to donate could potentially be the answer to the shortage. As technology advances, and people are living longer lives, the need will continually increase. Transplant tourism to foreign countries is unsafe and untraceable. If incentives were offered to those willing to donate, donation procedures could be safely monitored by professional surgeons and doctors. It is completely legal to offer compensation to a woman for egg donation to create life, so what is the problem with offering incentives for organ donation to prolong another life? How many more people on organ waiting lists need to die before the issue is talked about? This is a severe problem, and actions need to be made to educate the public and bring awareness to the problem.