Primary Care Providers’ Knowledge and Attitudes towards Organ Donation and Deemed Consent in Nova Scotia, Canada

Context: On January 18, 2021, Nova Scotia implemented a deemed consent model for organ and tissue donation, the first jurisdiction in North America to do so. This means that all adult Nova Scotians are considered to have consented for deceased organ donation unless they explicitly opt out. Primary care providers (PCPs) have important roles in organ donation systems, including promoting organ donation with patients (i.e., raising awareness) and supporting families when they are asked to donate their loved one’s organs.

Objective: We sought to understand PCPs’ knowledge, attitudes, and experiences with organ donation and transplantation, including a legislated deemed consent model.

Study Design and Analysis: An electronic, self-administered survey to query respondents on their experiences with, knowledge of, and attitudes around organ donation and deemed consent, and barriers and opportunities to the implementation of deemed consent in clinical practice. Survey results were analyzed using descriptive statistics.

Setting: Nova Scotia, Canada.

Population Studied: Practicing PCPs.

Results: Two hundred and eleven PCPs responded to the survey. The vast majority had favorable attitudes around organ donation (99.4%), and most supported a deemed consent model (83.9%). Half (52.6%) of those who opposed deemed consent felt it was a violation of an individual’s rights. Nearly three-quarters (72.6%) of PCPs said they have a conversation around organ donation only if it is initiated by the patient. Approximately half (51.8%) agreed that organ donation should be discussed yearly with patients. When asked specific knowledge questions, 71.0% correctly identified active HIV as a contraindication to organ donation, whereas 25.6% incorrectly identified a history of intravenous drug use as a contraindication. Nearly two-thirds (64.9%) and three-quarters (75.6%) were confident in their understanding of donation after neurological death and donation after cardiocirculatory death, respectively.

Conclusions: We found positive attitudes around organ donation amongst PCPs, including high support for a deemed consent model. However, specific knowledge gaps were identified that should be addressed as the new model is rolled out.