Premier Stephen McNeil says it's time to have a conversation about presumed consent for organ donation.

McNeil told reporters Thursday he believes people in the province are ready to consider the idea of having to opt out of being a donor, rather than opt in.

"On a personal note, I believe it's something we should be seriously considering," he said.

Adding help, not removing control

The premier, who has signed his donor card, said he believes presumed consent also makes it easier for health-care providers when it comes time to talk to loved ones about organ donation, without taking control away from next of kin.

"Reverse onus doesn't mean that it happens automatically," he said.

"Families always have the ability to say no."

Health Minister Leo Glavine previously floated the idea of reverse onus, but the government never moved ahead with it.

Presumed consent not enough on its own

James Breckenridge, president and CEO of the Canadian Transplant Society, said a presumed consent program would make a huge difference, but he cautioned that it alone isn't enough.

Such a move would also require changes to health-care infrastructure, he said. That's because most provinces don't have the capacity to take on additional transplant work.

"You need a transplant centre, doctors, transplant nurses, aftercare, you need all kinds of people involved before you can just say, 'OK, we're all presumed consent,' and then have a [glut] of organs available and then nobody to take them or no way of giving them to a recipient."

The Canadian Transplant Society says the national wait list for organs is on the rise. (Sean Gallup/Getty Images)

Part of the challenge for some people, said Breckenridge, is the notion of having the government tell them what to do. There are also potential Charter of Rights and Freedoms implications, he said.

But there is no denying the need for more donors.

National wait list keeps growing

The national wait list for solid organs — such as hearts, kidneys and lungs — is about 4,500, and increases by several hundred people each year, said Breckenridge. There are also about 3,000 people waiting for cornea transplants.

"We're going backwards as far as getting that wait list down," he said.

Nova Scotia does a very good job getting the word out about organ donation and in general does a good job considering the size of the province and available resources, he said.

While the national average for organ donors is about 20 per cent, in Nova Scotia it's about 52 per cent.

But like everywhere else in the country, said Breckenridge, it's not enough.