Summary#
Bill 4, the Peter Kormos Memorial Act (Saving Organs to Save Lives), 2025, would amend Ontario’s Gift of Life Act and Connecting Care Act, 2019. It would change the default for removing and using tissue after death: for people aged 16 or older, tissue could be used unless an objection is made; for children under 16, a parent or guardian’s consent would be required. The bill’s stated goal is to support tissue donation, transplant and other uses.
- Ontario Health, called the “Agency” in the Gift of Life Act, would have to establish and maintain a registry of objections and of consents for children under 16.
- A person aged 16 or older could object in writing, orally with two witnesses, or by a recorded message, and must communicate the objection to an attending physician or the Agency.
- In specified circumstances, a person from a listed family or next-of-kin hierarchy could object on someone else’s behalf. They could not do so if they had reason to believe that person would not have objected.
- A designated facility would have to make reasonable efforts to contact a patient or substitute if the Agency says contact is required. The contact duty described in the bill is about tissue removal for transplant.
- Ontario Health’s stated objects would include coordinating and supporting tissue removal, donation, transplant and other uses, including work with designated facilities.
What it means for you#
- People aged 16 or older: After your death, tissue could be removed for therapeutic purposes, medical education or scientific research, including transplant, unless you or an eligible person acting on your behalf objects. You could object to all tissue or specify particular tissue or body parts.
- Children under 16: A parent or guardian would have to consent before tissue could be removed after the child’s death. Without that consent, removal would not be allowed.
- Family and next of kin: If a person dies without objecting, or is near death and a physician considers them unable to object, eligible people could object in a set order: spouse, children, parents, siblings, other next of kin, then certain people in possession of the body.
- Patients and designated facilities: The Agency would decide, in consultation with a facility, whether the facility must contact a patient or substitute about objection or consent for transplant. If told to do so, the facility must make reasonable efforts to contact them.
- Ontario Health: It would have to operate the registry and take on the listed coordination and support role. The bill does not create a separate independent agency.
Money#
No cost information is in the available material.
- Ontario Health would have to establish and maintain the registry, but the bill gives no cost or staffing estimate.
- Designated facilities may need staff time to make required contact efforts; no cost estimate is provided.
- The bill does not set a fee, tax, fine or benefit.
What is unclear#
- The supplied material does not include the full current Acts, so the exact existing duties and definitions—including the meaning of “tissue” and “Agency”—cannot be checked against current law.
- The bill does not set out how the Agency decides whether a facility must contact a patient, or how the Agency’s contact and staff requirements would work in practice.
- The registry would record objections and consents for children under 16 sent to the Agency. The bill does not explain how people can check or correct entries, or who may access the registry.
- The bill does not explain how staff would confirm objections or consents communicated to a physician but not sent to the Agency.
- The bill would come into force on Royal Assent, but the supplied material does not say whether rules or operational details would be ready by then.
Case for#
- A possible argument for the bill is that removing the need for prior consent for adults could make more tissue available for transplant, education and research.
- The bill preserves a way for adults to refuse and gives certain relatives a limited way to object when the person did not object or could not do so near death.
- A registry and a coordination role for Ontario Health could help facilities handle objections and tissue removal in a more coordinated way.
- Requiring parent or guardian consent for children under 16 gives them a different safeguard from the adult default.
Case against#
- The bill reverses the default for adults: tissue could be used without their prior consent if no objection is recorded or otherwise communicated.
- The bill allows tissue use for education and research as well as transplant; a person may not expect all those uses to follow from the same default.
- It is unclear how objections will be found and acted on quickly, especially if they were not sent to the Agency and entered in its registry.
- The Agency would decide when facilities must make contact, but the bill does not set out the decision rules or an appeal process.
- Ontario Health and designated facilities would take on duties without a cost estimate or staffing plan in the supplied material.