J Med Ethics 31:188-191 doi:10.1136/jme.2003.002931
  • Clinical ethics

An antidote to the emerging two tier organ donation policy in Canada: the Public Cadaveric Organ Donation Program

  1. S Giles
  1. Toronto General Hospital, University Health Network, 200 Elizabeth Street, Room ESG-470, Toronto, ON Canada M5G 2C4;
    • Received 2 January 2003
    • Accepted 4 September 2003
    • Revised 30 June 2003


    In Canada, as in many other countries, there exists an organ procurement/donation crisis. This paper reviews some of the most common kidney procurement and allocation programmes, analyses them in terms of public and private administration, and argues that privately administered living donor models are an inequitable stopgap measure, the good intentions of which are misplaced and opportunistic. Focusing on how to improve the publicly administered equitable cadaveric donation programme, and at the same time offering one possible explanation for its current failure, it is suggested that the simple moral principle of “give and you shall receive”, already considered by some, be extended further. This would allow for those who are willing to sign up to be a public cadaveric donor be given a priority for receiving an organ donation should they ever require it. It is argued that this priority may provide the motivation to give that is so far lacking in Canada. This model is called the Public Cadaveric Organ Donation Program.