A Qualitative Content Analysis of Comments on Press Articles on Deemed Consent for Organ Donation in Canada

Clin J Am Soc Nephrol. 2022 Nov;17(11):1656-1664. doi: 10.2215/CJN.04340422. Epub 2022 Oct 26.


Background and objectives: In 2019, two Canadian provinces became the first jurisdictions in North America to pass deemed consent legislation to increase deceased organ donation and transplantation rates. We sought to explore the perspectives of the deemed consent legislation for organ donation in Canada from the viewpoint of individuals commenting on press articles.

Design, setting, participants, & measurements: In this qualitative descriptive study, we extracted public comments regarding deemed consent from online articles published by four major Canadian news outlets between January 2019 and July 2020. A total of 4357 comments were extracted from 35 eligible news articles. Comments were independently analyzed by two research team members using a conventional content analysis approach.

Results: Commenters' perceptions of the deemed consent legislation for organ donation in Canada predominantly fit within three organizational groups: perceived positive implications of the bills, perceived negative implications of the bills, and key considerations. Three themes emerged within each group that summarized perspectives of the proposed legislation. Themes regarding the perceived positive implications of the bills included majority rules, societal effect, and prioritizing donation. Themes regarding the perceived negative implications of the bills were a right to choose, the potential for abuse and errors, and a possible slippery slope. Improving government transparency and communication, clarifying questions and addressing concerns, and providing evidence for the bills were identified as key considerations.

Conclusions: If deemed consent legislation is meant to increase organ donation and transplantation, addressing public concerns will be important to ensure successful implementation.

Keywords: Canada; deemed consent; opt-in; opt-out; organ donation; public opinion; transplantation.

MeSH terms

  • Canada
  • Humans
  • Informed Consent
  • Organ Transplantation*
  • Qualitative Research
  • Tissue Donors
  • Tissue and Organ Procurement*