• Robin Urquhart, Jessica Vickery, Cynthia Kendell, Jade Dirk, and Stephen Beed.
• Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Room 413, Centre for Clinical Research, 5790 University Avenue, Halifax, NS, B3H 1V7, Canada. robin.urquhart@nshealth.ca.
• Can J Anaesth. 2024 Mar 1; 71 (3): 400407400-407.

PurposeIn 2021, Nova Scotia, Canada, became the first jurisdiction in North America to adopt a deemed consent organ donation system under its revised Human Organ and Tissue Donation Act. This study sought to understand the early experiences of program staff and clinicians involved in implementing this legislation.MethodsWe conducted semistructured interviews with members of the provincial organ donation program and intensive care unit and emergency department clinicians (n = 14). Two investigators coded transcripts of interviews, then categorized the coded data into themes.ResultsWe identified four key themes: 1) legislation has limited impact on daily practice; 2) legislation does not address existing barriers; 3) legislation aids conversations with donor families; and 4) legislation should provide more autonomy to patients and families, not less.ConclusionDeemed consent legislation had limited impact on clinician's day-to-day practices, because of lack of infrastructure changes and infrequent donation opportunities. Nevertheless, participants felt the introduction of deemed consent in Nova Scotia eased conversations between families of potential donors and clinicians. These findings should be used to inform ongoing implementation of deemed consent and be considered by those contemplating similar legislative changes.© 2023. Canadian Anesthesiologists' Society.

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