CELPIP Reading Part 4 Practice Test: Presumed Consent For Organ Donation Debate

Opinion surveys consistently find that most Canadians support organ donation, yet only a fraction have formally registered their intentions. The provincial government believes a simple legislative change can close that discrepancy. Under a bill introduced last week, every adult resident would be presumed a willing donor unless he or she had opted out. Nova Scotia pioneered such a system in 2021.

Health Minister Rachel Ostrowski considers the reform long overdue. Hundreds of residents languish on waiting lists, some destined to die before an organ becomes available, and the existing arrangement places the onus on individuals who rarely act. “Their inaction doesn’t reflect objection. It reflects preoccupation with everyday responsibilities,” she maintains. Anyone could withdraw online at any time.

Dr. Kwame Asante, a transplant program director, supports the bill while cautioning that its promise is oversold. “Legislation alters the default, not what happens at the bedside.” Relatively few deaths occur in circumstances permitting donation, and there a missed referral or a shortage of intensive care beds can matter far more than any registry. Countries with the strongest records, he contends, owe their achievements to specially trained professionals in every hospital who identify potential donors and approach grieving families. Without funding for those positions, the government will have “bought itself a headline, not more organs.”

Bioethicist Lorraine Beaudet objects that interpreting silence as consent undermines the very notion of a gift. Recent immigrants, people who disregard the news and those without dependable internet access could be enrolled unknowingly. “The status quo’s unsatisfactory, I grant you, but this new default is a nudge being marketed as a cure.” She would prefer that every adult be required to answer the question, perhaps when renewing a health card, instead of having the government answer it for them.

Darren Fikre, whose teenage son waited nearly two years for a kidney, has little patience for such reservations, having repeatedly been told the system needed further investigation. “Families would retain the final word, since physicians won’t override a refusal,” he stresses. “This legislation simply starts the conversation from yes.”

As an intensive care nurse, I agree with the minister that most people who never register 6. Choose…object on principlenever act on good intentionshave quietly opted out alreadyknow nothing about donation, yet Dr. Asante has identified the real bottleneck. In my hospital, possible donors slip through simply because 7. Choose…their families refuse to discuss itthe registry is out of dateno trained eye identifies themthe law demands written consent. No new default will fix that.

Ms. Beaudet’s 8. Choose…call for further studypublic awareness campaignplan for a family veto“ask, don’t presume” alternative strikes me as a sensible compromise that respects choice while tackling low registration. Mr. Fikre is right that, in practice, 9. Choose…families still hold the vetodoctors seldom consult relativeshospitals could proceed regardlesshis son’s wait would be shorter. But if the province genuinely wants to 10. Choose…earn praise for acting fasttrim what hospitals spendcut the opt-out rateturn headlines into transplants, it must open its wallet, not merely pass a law. Otherwise, we will be having this same debate in five years.