Quebec Switches to Opt-Out Organ Donation

Summary#

This Quebec bill would switch organ and tissue donation to “presumed consent.” That means adults would be considered donors after they die unless they clearly say no while alive. The goal is to make donation easier and help more patients get transplants.

• Adults are presumed to have agreed to donate organs or tissues after death unless they recorded a refusal.
• For children under 14, a parent or guardian must consent. For other minors with no known wishes, a person who could consent to their care may consent.
• Before any removal, hospitals must take reasonable steps to ask close relatives if the person had refused. In urgent cases, two doctors can allow donation without this check.
• The provincial health insurance board’s register will track both consents and refusals, and notices will explain the new default and how to opt out.
• Some identity details can be shared with organ-donation coordination groups, on request, to organize possible donations when there is no recorded refusal.
• The Health Minister must report on how the law is working five years after it starts, and every five years after that. The law takes effect on a date set by the government.

What it means for you#

• Adults in Quebec

  • If you do nothing, you will be treated as an organ and tissue donor after your death.
  • You can refuse at any time. You can record a refusal with the health insurance board (RAMQ) or through a notary. You can also change your mind later.
  • If you have not refused, some of your basic identity information may be shared with donation coordinators to check matches after your death.

• Families and close relatives

  • Hospital staff will check the registers and will ask you what the person’s wishes were.
  • If the person refused while alive, donation will not happen.
  • If there is no refusal on record and no known objection, donation may go ahead.
  • In urgent cases, if two doctors sign that donation could save a life or greatly improve one, the usual family check may not happen first.

• Parents and guardians of minors

  • For a child under 14, your consent is required.
  • For a minor with no known wishes, a person who could consent to the child’s medical care may consent to donation.

• Health workers and hospitals

  • You must take reasonable steps to confirm with close relatives that the deceased did not refuse donation, unless two doctors certify an urgent need with a strong chance to help.
  • You can request limited identity information from RAMQ and the notaries’ register to coordinate donations when there is consent or no refusal.
  • Access to the notaries’ register is restricted to the person, their authorized agent, a notary, or someone designated by the Health Minister for donation coordination.

Expenses#

No publicly available information.

Proponents' View#

• Presumed consent will likely increase the number of available organs and tissues, helping more people get transplants sooner.
• It keeps personal choice: anyone can refuse at any time and can change their decision later.
• Adding refusals to the registers makes records clearer and easier to check, which can speed up decisions.
• Clear rules reduce pressure on grieving families to decide in a crisis.
• The urgent-care exception could save lives when time is critical.

Opponents' View#

• Default consent may feel like consent without a clear “yes,” which could reduce public trust.
• Families might feel overlooked if donation proceeds quickly in urgent cases.
• If records are missing or out of date, organs could be removed against a person’s wishes.
• People may not know about the need to opt out, so strong public education would be required.
• Sharing identity details with coordination groups raises privacy concerns if not carefully managed.