About Transplant Bioethics

​​​​​​The Ajmera Transplant Centre at UHN is committed to doing what is right, fair and ethical. We practice ethical standards used by many transplant programs in North America, and we work closely with UHN’s Bioethics Program. The Bioethics Program and Transplant work together to develop ethical policies and guidelines such as the Ethical Guidelines for the Evaluation of Living Organ Donors.

Organ Transplantation Ethics

A person must be pronounced dead before it is morally acceptable to remove his or her vital organs for the purpose of donating them. A person is considered dead if he or she has permanently lost brain function or when their heart has stopped beating and their lungs have stopped breathing for them.

In Canada, a person must give consent for his or her organs to be removed after death for the purpose of donating them. If a person’s wish is unknown, the family may give consent on his or her behalf.

In Canada, as in most Western countries, there are more people in need of organs for transplantation than there are organs available. It is generally considered morally right to give organs first to the people who are the sickest and have waited the longest. In Ontario, the Trillium Gift of Life Network manages the list of people who are in need of organs.

There are many questions considered when it comes to organ donation from a living donor. Is the donor making a free and informed decision to donate? Will the donor have the necessary support after the donation? Is the recipient willing to accept the living donor‘s organ? Is there likelihood of psychological benefit to the living donor by donating? Do the overall likely benefits outweigh the potential harms for the living donor and the recipient?

A living donor usually chooses the recipient of his or her organ, and the recipient is most often related to the donor by blood or friendship. A person might occasionally donate an organ to a stranger, usually to those who need it most. UHN will evaluate both related and unrelated donors as potential donors. In Canada, it is illegal to sell one’s organs.

Where Can I Learn More? You can learn more about Bioethics at the UHN Bioethics Website.

Organ Transplant Organizations   

Canadian Blood Services – Canadian Blood Services has assumed a number of responsibilities related to organ and tissue donation and transplantation (OTDT). Much of this work takes the form of engaging OTDT professionals in the areas of leading practice, system design, system performance improvement and the development of three important organ registries. Learn more about Canadian Blood Services

Canadian Society of Transplantation – The Canadian Society of Transplantation is the organization of professionals dedicated to leading, advancing, and advocating for patient care, research, and education in donation and transplantation in Canada. Learn more the Canadian Society of Transplantation 

Trillium Gift of Life Network – Trillium Gift of Life Network is Ontario’s operational service agency on organ and tissue donation. Learn more about the Trillium Gift of Life Network 

Canadian National Transplant Research Program (CNTRP) – The Canadian National Transplant Research Program (CNTRP) is a national research network designed to increase organ and tissue donation in Canada and enhance the survival and quality of life of Canadians living with a transplant. Learn more about the Canadian National Transplant Research Program​ 

Patient Advocacy Organizations

Canadian Liver Foundation – Founded in 1969 by a group of doctors and business leaders concerned about the increasing incidence of liver disease, the Canadian Liver Foundation (CLF) was the first organization in the world devoted to providing support for research and education into the causes, diagnoses, prevention and treatment of all liver disease. Learn more about the Canadian Liver Foundation 

Canadian Lung Association – The Canadian Lung Association works at the national, provincial and community levels to improve and promote lung health. It funds world-class medical research in Canada to find treatments- and ultimately a cure- for lung diseases. Learn more about the Canadian Lung Association 

Heart and Stroke Foundation of Canada – The Heart and Stroke Foundation, a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy. Learn more about the Heart & Stroke Foundation 

Kidney Foundation of Canada – Established in 1964, the Kidney Foundation of Canada has helped millions of Canadians suffering from kidney failure and related illnesses. This site has many useful links for health care professionals and the public. Learn more about the Kidney Foundation of Canada 

Civitan – Civitan, which is a broader social organization, has a focus on lung health and transplantation, at least locally. There is a distinct organization called the Toronto Lung Transplant Civitan Club that provides assistance to lung transplant patients. Learn more about the Toronto Lung Transplant Civitan Club 

Further Reading

For Adults (Transplantation Ethics)

Ethical Issues in Pediatric Organ Transplantation
edited by Rebecca A. Greenberg, Aviva M. Goldberg and David Rodrigues-Arias, Springer, 2016
This book is recommended for working with people donating to pediatric recipients. There is a strong Canadian representation among the authors/editors.

Transplantation Ethics, Second Edition
Robert M. Veatch and Lainie F. Ross, Georgetown University Press, 2015
This book offers a general and systematic overview of organ transplantation ethics.

The Report of the Citizens Panel on Increasing Donation Rates (2007)
This report includes several recommendations for increasing organ donation rates in Ontario based on the views and opinions of Ontario citizens.

Ethical, Legal, and Social Issues in Organ Transplantation
edited by Thomas Gutmann, Abdallah S. Daar, Robert A. Sells and Walter Land, Pabst Science Publishers, 2004

The Ethics of Organ Transplantation (Advances in Bioethics, Book 7)
edited by Wayne Shelton and John Ballint, Emerald Group Publishing, 2001

The Ethics of Organ Transplants. The Current Debate
edited by Arthur L. Caplan and Daniel H. Coelho, ​​Prometheus Books, 1998
This book includes many articles covering major ethical issues in organ transplantation such as whether organs should be taken automatically from the deceased and whether people should be allowed to sell their organs.

For Children (General Information on Transplantation)

Karen Walton, How Will They Get That Heart Down Your Throat?: A Child's View of Transplants, E. M. Press, 1997. This book tells the story of a kindergarten teacher who underwent a heart transplant in May of 1995. In doing so, the book provides information about the process of organ donation (ages 9-12).

Ramona Wood, Now Caitlin Can: A donated organ helps a child get well, Abc Press, 2004. This book shows how the loss of a sibling can help other people (ages 4-8).​