*Purpose: In 2019, two Canadian provinces (Alberta and Nova Scotia) became the first jurisdictions in North America to pass presumed consent legislation to increase deceased donor organ transplantation. Under this law, adults will be presumed to consent to organ donation unless they register an opt-out decision. Public trust and support for the policy is critical to its success and fears and misconceptions need to be identified and addressed.

*Methods: We performed a qualitative descriptive study to explore public perceptions and perceived implications of presumed consent for organ donation in Canada. We extracted public comments from online articles published by 4 major Canadian news outlets about the presumed consent policy from January 2019 to July 2020. Articles were excluded if they: 1) were not in the English language, 2) had no comments, or 3) did not focus primarily on presumed consent. Comments linked to the articles were imported into NVivo. Conventional content analysis (i.e., coding and grouping similar concepts and developing themes) was completed independently by two authors.

*Results: We identified 180 news articles; 36 were eligible for study inclusion and contained a total of 4,357 comments for data analysis. Three primary themes emerged: polarized positions on the bill, perceived implications of the bill, and questions or concerns to address. The majority of commenters appeared to be either for or against the bill, with few people reporting neutral views. This resulted in tensions between the two sides. The perceived positive implications of the bill included: a) it aligned with the views of the majority of Canadians, b) it had lifesaving and financial benefits, and c) it was a timely and sensible solution. The perceived negative implications included the bill being: a) a violation of rights, b) having the potential for abuse, and c) it being a slippery slope (e.g. it could lead to a monetized organ trade). Improving government transparency and communication, clarifying questions and concerns, and providing evidence for the bill were identified as key concerns that need to be addressed prior to implementation.

*Conclusions: Public perceptions of the presumed consent bill for organ donation in Canada are influenced by various factors. If the presumed consent laws are meant to increase organ donation and transplantation, public education and support will be important to ensure successful implementation.

« Back to 2021 American Transplant Congress