Living Donor Recognition Medal Bill

Moved third reading of Bill C-234, An Act respecting the establishment and award of a Living Donor Recognition Medal.

Senator Patterson, would you take a question?

Thank you, Senator Patterson, for bringing that nuance to the medal. Is there any particular reason why you did not bring an amendment to this bill to fix that situation and bring it into balance in the work that is being done by our veterans or people who work on behalf of Canada in the army?

Honourable senators, I am pleased to rise today as the friendly critic of this bill.

As I mentioned at second reading in the spring, I am personally affected by this issue. Thanks to the generosity of living donors, two of my close friends are still with us today. They are among the lucky few who have received life-saving transplants.

I worked for the Government of New Brunswick for many years, and I have always been proud of the work that my province does to promote organ donation. Successive governments for our province have taken significant action to encourage people to make this essential sacrifice.

Along with Nova Scotia, New Brunswick is one of two Canadian provinces to have introduced a program for opting out of organ donation and post-mortem procedures. That means that adults are automatically considered donors after their death, unless they have actively completed a form to opt out. I mention that to highlight the broad consensus that exists across the political spectrum on issues such as this. New Brunswick and Nova Scotia have succeeded in advancing these policies because politicians set aside their differences and worked for the common good.

The passage of Bill C-234 by the House of Commons in the spring further illustrates this broad consensus. As the bill’s sponsor noted in his speech, MPs from all parties were eager to rally behind this initiative.

Of course, as we know, this bill doesn’t deal with posthumous donations. This bill seeks to provide long-overdue recognition for living donors.

Last spring, I made a point of recognizing that the sponsor of this bill in the other place, MP Ziad Aboultaif, is himself a living donor. On December 8, 2003, he donated part of his liver to save the life of his son Tyler. I would encourage you all to read the MP’s speech when he introduced this bill. It is very moving.

Thanks to his efforts, Bill C-234 will recognize the remarkable individuals who make the selfless and courageous choice to become living donors. It would do so by creating a living donor recognition medal.

I would remind you all that the scope of Mr. Aboultaif’s original bill was broadened through amendments at the committee level. What began as a bill designed to honour living organ donors was expanded to include all living donors, including those who donate stem cells and those who demonstrated a particularly exceptional lifelong commitment to giving blood.

There are many reasons to support this bill, not the least of which is that it can help encourage more donations at a time when our health care system desperately needs them. There are currently approximately 4,700 people in Canada waiting for transplants. Three quarters of those people are waiting for a kidney. They could all be helped through living donors.

As others have highlighted in their support of this bill, living donations are more successful than posthumous ones. Proper matches are easier to find through living donations, and being able to schedule procedures ahead of time leads to much better health outcomes. From a medical perspective, a posthumous donation is an option of last resort.

Encouraging more living donation is not only a humanitarian gesture, but it is also a sensible decision. Dialysis costs around $100,000 per year. A transplant costs $70,000.

I firmly believe that this bill will raise public awareness and spark a debate about living organ donation. It will encourage more people to take an interest in organ donation and the inestimable impact it can have.

If this bill is passed, Canada will become the second country in the world to include living donors in its national honours system. By honouring living donors, Canada could lead by example, highlighting the importance of living organ donation and paying tribute to those who give the gift of life.

Going off script for a moment in reaction to Senator Patterson’s remarks, I agree with everything the senator has said in regard to post-nominal letters and as they apply to Sacrifice Medals or any other medals that our military personnel receive and that are very well deserved.

However, I do feel it’s a separate issue that can’t necessarily be addressed by this bill. That’s why I think the idea of amending this bill wasn’t necessarily the right approach. I would gladly be the friendly critic to your bill if you ever wanted to address this issue and fix it for the future.

I hope you will join me in supporting this highly commendable initiative, Bill C-234.

Thank you. Meegwetch.

Honourable senators, I rise today at third reading as the Senate sponsor of Bill C-234, An Act respecting the establishment and award of a Living Donor Recognition Medal.

When I first spoke to this legislation at second reading, I described living organ donation as one of the clearest expressions of selflessness in our society. Following the Standing Senate Committee on Human Rights’ study of this bill, and having heard directly from living donors, transplant advocates and experts in Canada’s honours system, I am more convinced than ever of the importance of recognizing these extraordinary Canadians.

Before turning to the substance of the bill, I want to express my sincere appreciation to my colleague in the other place member of Parliament Ziad Aboultaif, the sponsor of this legislation.

Mr. Aboultaif has been a tireless advocate for living organ donation. His commitment is not simply legislative or political. It is deeply personal. In December 2003, he donated part of his liver to his son Tyler in an effort to save his life. His son subsequently received another life-saving organ donation from an anonymous donor in Quebec.

That experience gave Mr. Aboultaif a profound understanding of what living donation means, both for the person giving and for the person receiving. He has taken that experience and turned it into a national initiative intended to recognize thousands of Canadians who have made similar sacrifices.

I thank him for his leadership, his perseverance and his willingness to work collaboratively with parliamentarians from all parties to advance this important legislation. I also thank him for inviting me to sponsor this bill in the Senate. It has been an honour to do so.

Honourable senators, this legislation has demonstrated something we do not always see in Parliament: a willingness to set aside partisan differences in pursuit of a common objective. The bill received unanimous support in the other place, and its progress through Parliament has reflected a shared recognition that living donors deserve our gratitude.

This is not a Conservative issue, a Liberal issue or an issue belonging to any particular political party. It is a Canadian issue, and it speaks to values that unite us: compassion, generosity, service and a willingness to help others, sometimes at considerable personal cost.

At its core, Bill C-234 is straightforward. It would establish a national medal to recognize eligible individuals who voluntarily donate organs, tissue, stem cells or blood while living. The legislation also provides for the administration of the medal and the use of the post-nominal letters L.D.M.

The objective is not to create a financial incentive for organ donation. It is not to commercialize transplantation, alter medical eligibility standards or interfere with provincial health care systems. It is to recognize extraordinary acts of generosity and, through that recognition, increase public awareness of living donation.

Honourable senators, Canada has a long tradition of recognizing individuals who demonstrate courage, sacrifice and service. We honour military service, acts of bravery, contributions to public life and exceptional volunteerism. Yet there are Canadians who willingly undergo invasive medical procedures, accept personal risk and give a part of themselves so that another person may live. Until now, we have not had a dedicated national medal recognizing that particular contribution. Bill C-234 seeks to address that absence.

The Standing Senate Committee on Human Rights heard compelling testimony that reinforced both the importance of this legislation and the need to implement it responsibly. I want to thank the committee chair, Senator Paulette Senior, and my colleagues on the committee for their thoughtful examination of the bill. I also want to acknowledge the witnesses who shared their experiences, their expertise and, in some cases, deeply personal stories. Their testimony helped move our consideration of this legislation beyond the principle of recognition to the practical question of what this recognition can mean for Canadians.

One of the most memorable witnesses was Shelley Hunt, a living kidney donor from British Columbia. In 2014, Ms. Hunt donated a kidney through a paired exchange program. She had initially intended to donate anonymously. During the process, however, she met a young boy named Aidan, who needed a kidney and was approximately the same age as her own son.

Although she was not a direct match for Aidan, the paired exchange program allowed her donation to help another recipient, while Aidan received a kidney through the exchange. When Ms. Hunt appeared before our committee in June, she shared that Aidan had recently graduated from high school, a joyous achievement by any measure. A young boy who needed a kidney was able to grow up, continue his education and reach an important milestone in his life. His family was able to watch him do so. That opportunity was made possible through the generosity of someone willing to help. Ms. Hunt told the committee that seeing Aidan healthy and graduating was all the recognition she personally needed. However, she also made an important point: She had not known living kidney donation was possible until she received information about it. A simple piece of information changed her life and ultimately helped change someone else’s. That is precisely why awareness matters.

A Canadian cannot consider becoming a living donor if they do not know that living donation is possible. They cannot make an informed decision if they do not understand the process. They may never have that important conversation with their family unless something encourages them to begin it. Bill C-234 creates another opportunity for those conversations to take place.

Colleagues, the committee also heard from Craig Lindsay of the Kidney Foundation of Canada. Mr. Lindsay spoke from the perspective of someone who had experienced kidney failure and ultimately received a transplant from a deceased donor. He described the uncertainty of waiting for an organ and the profound difference transplantation can make in a person’s life. He also explained that one of the greatest barriers to living donation is a lack of awareness. Many Canadians simply do not know enough about living donation to consider it.

Mr. Lindsay emphasized that recognition can also help tell stories, generate awareness and encourage conversations that might otherwise never occur. We should not suggest that the creation of a medal will automatically result in more organ donations. There is no guarantee of that. But we can reasonably recognize its potential to increase awareness, encourage informed discussion and inspire Canadians to learn more.

Behind every Canadian waiting for a transplant is an individual and a family living with uncertainty: parents waiting for their children, spouses hoping for more time together, and people whose lives have been interrupted by illness, dialysis, repeated medical appointments and the uncertainty of whether a suitable organ will become available. Some will receive the transplant they need; tragically, others will not.

Living donation cannot solve every challenge within Canada’s transplant system, but it can make a profound difference. If greater awareness helps even a small number of Canadians consider donation, that is an outcome worth pursuing.

Our committee also heard from Meghan Rozema of Alberta, whose experience demonstrates the extraordinary generosity that motivates living donors. Ms. Rozema donated part of her liver in 2021 and a kidney in 2023. Both recipients were anonymous. She has never met them. Imagine making the decision, not once but twice, to undergo a significant medical procedure to help someone you do not know. Like many living donors, Ms. Rozema is not seeking attention, but she recognizes that sharing her experience may encourage someone else to consider donating. That testimony captures the spirit of this legislation. The medal is not intended to reward people for seeking recognition; it is intended to recognize those who have already demonstrated extraordinary generosity and to provide an opportunity for their experiences to inspire others.

Honourable colleagues, we also heard about the important work already being done to recognize donors. Representatives of the Canadian Organ and Tissue Donors Association described their long-standing recognition program in Quebec. For more than two decades, that organization has honoured living donors through ceremonies involving the Lieutenant Governor of Quebec. More than 400 living donors have received recognition through that program. These initiatives demonstrate that recognizing living donors is neither a new nor an untested idea.

A federal medal should complement these existing initiatives rather than duplicate administrative processes unnecessarily. However, it should also provide something distinct: recognition at the national level. Whether a donor lives in Newfoundland and Labrador, Quebec, Alberta, British Columbia or Nunavut, the act of literally giving part of oneself to help another person deserves the same consideration.

Colleagues, our committee’s study was valuable not only because of the support expressed for the bill but also because witnesses raised legitimate questions about its implementation. Those concerns deserve to be acknowledged.

We heard from Christopher McCreery, an expert on Canada’s honours system, and Brigadier-General Marc Thériault, representing the Chancellery of Honours at the Office of the Secretary to the Governor General. They raised questions about eligibility, administration, costs and the proposed use of post-nominal letters. I appreciate their expertise and the constructive manner in which these concerns were presented.

We have a responsibility to ensure that national recognition is meaningful, credible and administered appropriately. At the same time, I believe it is important to recognize the considerable work that has already gone into refining this legislation.

Bill C-234 did not arrive in the Senate without careful consideration of its provisions. During its examination in the other place, the legislation benefited from extensive discussions and consultations, including with Rideau Hall, the Chancellery of Honours and the Department of Justice.

Several government amendments were developed through that process, with the support of the bill’s sponsor, MP Ziad Aboultaif. These were constructive amendments intended to strengthen the legislation, clarify its provisions and ensure that the proposed medal could be appropriately accommodated within Canada’s honours system.

That collaborative approach is worth emphasizing. It demonstrates that the legislation before us is not simply the original proposal brought forth by a private member. It is the product of consultation, compromise and careful parliamentary consideration.

I was particularly encouraged by a letter dated October 6, just one month ago, from the Honourable Dominic LeBlanc, President of the King’s Privy Council for Canada, addressed to the chair of our committee and distributed to its members.

Minister LeBlanc expressed his strong support for Bill C-234 and acknowledged the important work undertaken in the House of Commons to refine its provisions. He also made an observation about Canada’s honours system that I believe is particularly relevant to our deliberations. While the system is firmly rooted in history and tradition, it must also be capable of evolving to reflect the contributions that Canadians make to our country. That is an important principle.

Our honours system has developed over time because Canadians have recognized new and different forms of service worthy of national distinction. We heard from Senator Patterson regarding some of this for members of our military. The living donor recognition medal is consistent with that tradition. It recognizes a form of service that is extraordinary, deeply personal and, in many cases, life-saving.

The committee also heard questions about the proposed use of post-nominal letters. Those questions are understandable, particularly given the established conventions surrounding Canadian honours.

However, I believe it is important to recognize that this issue was not overlooked during the bill’s earlier consideration. In fact, it was specifically examined in the other place.

As Minister LeBlanc confirmed in his letter, the government introduced an amendment to provide greater clarity and confirm the appropriateness of post-nominals for recipients of the living donor recognition medal. The amendment received unanimous support.

The question, therefore, is not simply whether post-nominals are consistent with every existing convention. It is whether their inclusion serves a legitimate and meaningful purpose within this particular legislation. Colleagues, I believe that it does.

A medal is generally presented on a particular occasion. It may be worn at ceremonies or other formal events, but for most recipients, it will remain a personal keepsake. Post-nominal letters offer something different. They allow recognition to remain visible in everyday life.

They may appear in a professional biography, in correspondence, at a community event or alongside a person’s name in a public setting. When someone asks what those letters mean, an opportunity arises to explain living organ donation. That conversation may be brief, but it may also be the first time someone learns that a living person can donate a kidney or part of a liver to help another person.

It may encourage someone to seek further information, speak with their family or consider becoming donors themselves. That is not merely ceremonial recognition. It is a practical means of advancing one of the central purposes of this bill: public education and awareness.

This was also the point made by Minister LeBlanc, who emphasized that post-nominals would strengthen the medal’s ability to promote understanding of living donation. It is consistent with testimony we heard from living donors themselves, who explained that opportunities to share their experiences can encourage others to consider donation.

Recognition is not a competition. Recognizing living donors does not diminish the service of members of the Canadian Armed Forces, the courage of those who have risked their lives in the service of Canada or the accomplishments of recipients of other national honours.

Canada can honour different forms of service and sacrifice without diminishing any of them.

Honourable colleagues, I also believe there is value in maintaining a clear distinction between the purpose of this legislation and the delivery of health services.

Organ transplantation is, of course, a medical matter, but the recognition of exceptional service to Canadians is a matter for our national honours system.

The Chancellery of Honours has the experience, institutional knowledge and established role necessary to administer national distinctions. Health Canada and the organizations involved in organ donation and transplantation have important expertise they can contribute, particularly in relation to eligibility and verification. That expertise should inform the administration of the medal.

Colleagues, I recognize that every piece of legislation can be improved through careful examination, and I respect the responsibility of this chamber to undertake that work, though we must also recognize when significant consultation, parliamentary scrutiny and constructive amendments have already addressed the central issues before us.

In this case, the provisions relating to the administration of the medal and the use of post-nominal letters have received careful consideration. They form part of a balanced approach that seeks both to recognize living donors and to increase public awareness of their extraordinary contributions.

In my view, preserving that approach will allow us to move forward with a meaningful national recognition program, while ensuring that the focus remains where it belongs: the Canadians whose generosity and sacrifice inspired this legislation in the first place.

Our committee also heard that recognition alone is not enough to address every challenge faced by living donors. Transplant Québec raised important questions about the financial and insurance consequences that some donors may experience.

Living donors may face time away from work, travel expenses, recovery costs and other personal burdens. Some may encounter questions related to insurance. These issues deserve further attention.

The committee’s testimony provides a useful reminder that our work on supporting living donors should not end with the passage of this bill. Recognition should be part of a broader commitment to ensuring that Canadians who choose to help others are treated fairly and supported appropriately.

Throughout our committee hearings, one theme emerged repeatedly. Living donors generally do not act because they expect recognition. They act because someone needs help. Sometimes that person is a child, a parent, a spouse or a sibling. Sometimes it is a friend. And sometimes, colleagues, it is a complete stranger. But the motivation is fundamentally the same.

It is a willingness to make a personal sacrifice for the benefit of another human being. There is something profoundly Canadian about that.

Honourable senators, we often speak of service, compassion and sacrifice. Living donors put those values into action. They willingly accept personal risk and give something of themselves to change and sometimes save another person’s life.

Their extraordinary acts of generosity often take place quietly, far from public attention, yet their impact can last a lifetime. A child grows up. A parent comes home. A family is given more time together.

No medal can measure the value of such a gift, but it can return the gratitude of a nation, honour those who give without expecting anything in return and remind Canadians of the profound difference one person can make in another’s life.

When I agreed to sponsor Bill C-234, I did so because I believed its objective was both worthwhile and achievable. After hearing the testimony before the Standing Senate Committee on Human Rights, I remain convinced of that.

Honourable senators, we have heard the testimony, carefully examined this legislation and considered the questions surrounding its implementation. What remains is a simple but important principle: Canadians who willingly give something of themselves to improve or save another person’s life deserve the recognition and gratitude of their country.

Living donors do not seek honours. Their actions speak for themselves. We cannot repay what they have given, but we can ensure their extraordinary generosity is recognized and never forgotten. Bill C-234 gives us that opportunity, and I encourage all honourable senators to support it at third reading.

Thank you.

Are senators ready for the question?

Is it your pleasure, honourable senators, to adopt the motion?

Hon. Senators: Agreed.

(Motion agreed to and bill read third time and passed.)