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According to Ontario’s Trillium Gift of Life Network, 21 per cent of eligible registered donors had their wishes “vetoed” by family members — and their organs died with them — in 2015.

That’s 62 donors, each with the potential to save up to eight lives. While each province has laws that make registration legally binding, physicians have never gone against family wishes.

Highly trained organ donation coordinators such as Pam Nicholson — who are the only health-care practitioners allowed to approach families about the delicate topic — enter each conversation with knowledge of the potential donor’s registration status.

The main reason families don’t agree to donation is that “they just aren’t sure what their loved one would have wanted.” Knowing the registration status of a person is key in those cases, where four out five times, families agree with donation.

“Our job is to help the family make a decision that the person would have made if they were sitting in the room with us,” says Nicholson, who describes herself as an advocate for the person “in the bed who has registered.”

But she’s also there to advocate for the nearly 1,500 people who are on Trillium’s wait list.

“If we don’t speak for them, no one else will,” she says. “Every three days, someone in Ontario dies waiting for a lifesaving transplant.”

Legislation in most provinces and territories outlines legal authority for organ procurement from someone who has died. Written consent, such as an organ donor card or an online registration form, is legally binding. Family members can’t revoke that consent in most Canadian jurisdictions (the law is less clear in the North West Territories) — their refusal is legally meaningless.