Canada Revenue Agency Act
Bill to Amend--Second Reading
May 27, 2021
Moved second reading of Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors).
He said: Honourable senators, I rise today to speak in support of Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors). I chose to become the sponsor of this bill not as a favour to a caucus colleague but as a benefit for Canadians because I believe so strongly in what this legislation seeks to do.
Upon reflecting on this bill, I think most, if not all, of us would agree that this is one of those special pieces of legislation that truly transcends political lines. It is a very simple bill that could very simply save an immeasurable number of lives.
I would like to start by giving you a little history on the bill itself. It’s not the first time we’ve seen it come to this chamber for consideration. Its predecessor was Bill C-316 in the last Parliament. It was actually the same bill, and it passed with all‑party support through every stage in the House of Commons.
As a matter of fact, the current government believed in and supported this legislation to the point that they set aside funding for its implementation in the Fall Economic Statement 2018, so confident were they that it would pass. Kudos to them for taking that initiative.
Unfortunately, it did not pass, not because it faced opposition or contained flaws but, rather, because it died on the Order Paper, a victim of nothing more than a circumstance. Colleagues, it would be a real travesty to see this legislation come all this way again only to suffer the same fate.
This legislation and its consequences have been thoroughly examined. It has faced a level of scrutiny rarely seen by other bills. That’s not to suggest that we should just wave it through here. On the contrary, we are looking for your support to send this to committee so that it may receive its proper consideration in a timely fashion.
What Bill C-210 seeks to do is rather simple. It seeks a legal exemption to the Canada Revenue Agency Act that would allow an addition to the front page of the personal income tax return form. This line would grant individuals the ability to indicate their desire to become an organ donor.
Colleagues, I want to be clear: This would not in itself be consent for organ donation because, of course, that falls under provincial jurisdiction, varying from province to province, and would continue to do so under this legislation.
Under Bill C-210, the federal government would take the information it receives and relay it to the provinces. Depending on the manner in which the provinces conduct their registries, they will then be able to connect with Canadians who have indicated their desire to be organ donors. This is simply about providing greater exposure to the issue of organ donation with an emphasis on the voluntary nature of doing so and connecting Canadians with the resources to make their wishes known. That’s the goal of this legislation — to reach the 90% of Canadians who say they wish to be organ donors, while only 25% have actually registered.
One of the biggest complaints as to why there is such an expansive gap in those two numbers is that many Canadians don’t actually know how to go about becoming an organ donor. What this legislation will do is to close that gap by connecting people to the information they need to give consent for donation, no matter which province they reside in.
Colleagues, despite that overwhelming number of Canadians who say they would like to donate their organs, Canada has one of the lowest organ donation rates in the industrialized world. Meanwhile, more than 4,600 people in Canada are on a waiting list, hoping and wishing to receive organs. Sadly, while a single donor can save the lives of as many as eight people, in 2016, 260 Canadians died while awaiting organ donations.
Right now in Canada, it is estimated that only one out of six potential donors actually end up being a donor. How very tragic is that statistic? Imagine the lives that could be saved if we can close that gap.
Here we are with a second chance to do just that — close the gap between a desire to do so and the tools with which to do it. The manner in which this legislation seeks to accomplish this goal is simple and cost-effective, making it virtually seamless to implement — so much so that if we pass this legislation before we adjourn for the summer, the Canada Revenue Agency would be able to include it in next year’s package.
This wouldn’t require fancy system updates or huge additional costs. There also won’t be any privacy issues, since the federal and provincial governments already share the critical information gathered on tax returns.
This would solve the problem that comes from people moving from one province to another without updating their organ donation status. It would also address the issue of would-be donors who don’t have a driver’s licence, which is the method of registration currently used by most provinces. With more and more Canadians taking public transit and fewer and fewer getting their driver’s licence, this is a practical solution to identifying those Canadians who are unable to indicate their desire to be organ donors.
Allowing Canadians the opportunity to indicate their intention on a mandatory tax form is the simplest and most effective way to ensure they are able to follow through on properly and formally expressing their intentions.
If we do not pass this bill in a timely fashion, if we allow it to suffer the same fate as its predecessor — and I do not believe it is hyperbole to say this — tragically and needlessly it will cost the lives of many Canadians.
Dear colleagues, we have an opportunity to pass a piece of legislation that has come from the House of Commons with unanimous support. Getting the bill through in a timely fashion will be critical in fulfilling the desperate wishes of the thousands of Canadians who are waiting for a donor. Thank you, colleagues.
Honourable senators, I rise today in my role as the critic of Bill C-210, An Act to amend the Canada Revenue Agency Act (organ and tissue donors), to criticize it constructively, to endorse it and to urge all of you to support it and promote its timely passage through this chamber.
As we have heard from Senator Housakos, Bill C-210 allows the Canada Revenue Agency to assist provinces and territories that are interested in gathering information for their respective organ donor registries. This is done with two simple changes to the existing tax form: first, to allow a one-line addition to the tax form indicating intent to be an organ and tissue donor; and second, allowing that information to be shared by the Canada Revenue Agency with interested provinces and territories.
The bill is simple and sensible and it will have a substantial impact on vulnerable Canadians. It will help promote the availability of organs — such as kidneys, heart, lungs, liver and pancreas — and tissues — such as cornea, skin, bone and tendons — for those Canadians whose lives will be lengthened and improved by us passing it in time for the necessary changes to be made for the next taxation year. This bill will give gifts to many Canadians: the gift of life to some and, to others, the gift of meaning to a life lost.
Before I go any further, I want to remind all my colleagues in this place; if you have not already done so, to consider registering yourself as an organ and tissue donor, through whatever mechanism is in place in your province or territory. If you are from Nova Scotia, as am I, you are already opted in. If all other provinces and territories had a similar approach, we would not need this bill. However, until such time as that might occur, we do need this bill and we need it now.
Bill C-210 is simple. Rarely do we see such a straightforward legislative intervention that could have such a profound impact on improving and lengthening the lives of vulnerable Canadians. It will not force Canadians to register, thus it is permissive and not prescriptive. It does, however, provide another vehicle through which many Canadians can be nudged to consider donating their organs and tissues at the time of their death. With this simple option, those Canadians who choose to do so can easily opt in to provide the gift of life to others.
Dr. Stephen Beed, Medical Director of the Nova Scotia Organ Donation Program, calls this initiative “perfect, a way forward to address this substantive need.”
Bill C-210 is sensible. It does not force provinces or territories to modify or change their existing methods of organ and tissue donation requests. It does not intrude on provincial or territorial health care authorities. It does not force provinces or territories to accept or use the data that has been collected. It does, however, increase the pool of organ and tissue donors that each province and territory can call on to meet organ transplantation and tissue utilization needs in their jurisdictions.
Bill C-210 is substantial. It will have a positive impact on increasing the pool of potential organ and tissue donors to meet the needs of seriously and terminally ill Canadians who are waiting patiently and anxiously for the pager beep or phone call that tells them that a kidney or heart or lung has been matched to them, and that they can rapidly be taken into surgery and within a day or two emerge with a new lease on life.
Here I want to recognize the excellent work that Senator Mercer did in his pre-Senate life as executive director of the Kidney Foundation of Nova Scotia in promoting organ donation, and that he has continued to do during his Senate career. According to the Canadian Transplant Association, Canadian Blood Services, the Kidney Foundation of Canada and other data sources, the demand for organ donation falls well short of supply. Aggregating this data, we see that over the past few years about 4,500 Canadians annually are waiting for organ donation. Sadly, hundreds die before they can receive their life-saving transplantation — simply because there are not enough Canadians who have registered to donate.
This is a problem not of interest but of action. According to the Canadian Blood Services, about 90% of Canadians report that they support organ donation, but fewer than one third have registered their decision to do so. Often this is because it is not a convenient process. Improving opportunities to easily register to become a donor can help improve organ and tissue availability.
Let’s reflect on how organ donation occurs and the metrics around it. Some organs, such as kidneys, can be provided using a live donor. However, this makes up the minority of organ donation. Clearly, if a person has two of the same organs and can live a healthy life with only one of them — such as with kidneys — there may be a possibility that the person will part with one of their kidneys to save the life of someone who is in total kidney failure. Obviously, that cannot happen with a heart or lungs. Thus, organ and tissue donation that occurs at the time of death provides the majority of what is available to help others. One death donor can potentially provide enough organs and tissues to help up to 70 other people.
However, not everyone who dies is eligible to donate, for many different reasons, including but not limited to the presence of existing chronic or infectious diseases that make their organs and tissues unsuitable for donation. Some who die do so in extreme circumstances, so that their organs and tissues do not survive in a condition to support their use for donation. Some have family members who will not agree to the donation.
There is also not a simple one-to-one ratio between donor and recipient. The recipient must be a match for an organ from a donor, and that is not always easy to obtain. There are logistical and technical problems in obtaining, transporting and transplanting organs and tissues that create additional challenges. This is why there needs to be a much larger group of potential donors than recipients to meet needs.
Yet, the need for organs and tissues is not only currently unmet but is increasing. With an aging population and ongoing improvements in medical and surgical care, there is a greater call for organs and tissues. Currently, the available methods for obtaining registered donors are insufficient and the gap will only widen unless action is taken.
I have reviewed the importance of Bill C-210 and the positive impact that it will have; now for some constructive criticism.
This bill will be helpful but by itself it will not solve the mismatch between the need for organ and tissue donation and the availability of organs and tissues for donation. More action by provinces and territories is needed. Across Canada, a variety of different options for registration of varying degrees of effectiveness are in place. These include driver’s licence registration, health card registration and online portal registration. Nova Scotia is the only Canadian jurisdiction that uses an automatic opt-in approach to organ and tissue donation, and this approach is only about a year old. Other jurisdictions could study and learn from Nova Scotia’s pioneering approach.
Additionally, Bill C-210 does not address the complexities related to organ donation, including obtaining, transporting and transplanting. Canadian Blood Services operates the National Organ Waitlist and additional resources may be needed for that organization to support that work as numbers increase.
There will also be some costs incurred by the Canada Revenue Agency with the changes that this bill will require. I understand that the necessary funds have already been allocated since the 2018 Fall Economic Statement for this purpose and continue to be available today waiting for this bill to pass.
I thank Senator Housakos for his review of this and for his sponsorship of this bill and I thank all of you in advance for your support of it.
I would like to close by sharing some stories.
As you may recall, I made a statement in this chamber a few weeks ago in support of improving organ and tissue donation. In that statement, I recounted my personal journey through the untimely and tragic death of a young and wonderful human being, Hannah, and the gift of life that her death gave to others. I also recounted the gift of sight that her father received from tissue donors some years after her death.
I asked Hannah’s sister Martha, as someone who has both personal and professional experience with organ and tissue donation, to share her experiences with you. Here is a brief synopsis of what she would like us to know:
Proceeding with donation and knowing other families were getting the call they had been waiting for was the only silver lining in Hannah’s death. I still think of her recipients 10 years later, wonder if they made it and how their lives are going (her liver recipient was a little girl), so I am still constantly reminded of the gift of life she gave.
Speaking about her father’s receipt of the corneas, she writes:
The gift of sight is life-changing — dad would never have seen his grandkids without it, he would not be able to care for mom.
Now, speaking as a physician, she writes:
We see people die every year waiting for the life saving transplants they are hoping for . . . anything that increases the chance of us making our wishes known will likely increase the number of transplants available and the lives saved or improved.
Like some of you in this chamber, I have lived the grief that untimely and tragic death brings, but at the same time have experienced some comfort in knowing that this loss has resulted in a gift of organ and tissue donation — parenthetically, a gift to both those who have lost a loved one and those that have regained a life.
We in this chamber can be part of these human stories that will play out across Canada now and for decades to come because of the passage of Bill C-210.
Please join me and Bill C-210’s sponsor, Senator Housakos, in supporting the rapid transit of this bill through our chamber by now voting to refer it to committee for study and return. Thank you. Meegwetch.
Are honourable senators ready for the question?
Is it your pleasure, honourable senators, to adopt the motion?
Hon. Senators: Agreed.
(Motion agreed to and bill read second time.)
