Sexually active gay men no longer allowed to donate organs in Canada

CBC News reports that new Health Canada regulations proscribe organ donation from sexually active gay men, injection drug users and other groups considered to be high risk. These new regulations are similar to those governing blood donation.

Now, in addition to questioning potential organ donors on things such as travel, history of infectious disease, whether or not they have served jail time, and IV drug use, all of which are statistical risk factors for a variety of diseases, potential donors will also be questioned on their sexual orientation.  Men who have engaged in homosexual sex in the past five years will be excluded.

Up until now, Transplant programs have screened prospective organ donors, but in some cases use organs from people in high-risk groups if they’ve tested negative for diseases. The new regulations will put a stop to this practice.

Dr. Gary Levy, who heads Canada’s largest organ transplant program at Toronto’s University Health Network, argues that organ donors should not be held to the same high standards as blood donors given the higher stakes for potential organ recipients. Levy estimates that about 7% of available organs will be rejected by following the new rules. This is while approximately 4000 Canadians are waiting for an organ transplant.

Some in the gay community are complaining that these regulations are misguided. They argue that the focus should be on sexual behaviour, not orientation.

Gay activist Dean Robinson says that the big issue is anal intercourse, not whether the intercourse involves two men or a man and a woman.

It will be interesting to see how this plays out. I am curious as to the bases of this decision. I generally don’t expect homosexual bigotry from the Canadian government and so am giving them the benefit of the doubt right now. But at the same time, I wonder why Health Canada wants to fully proscribe organ donations from active sexual males. Why not just test prospective applicants and base decisions on test results, rather than on generalized risk factors that are known to simply say that one population is more likely to carry a disease than others, not that being a member of that population means that you have a disease. If the tests show that the person doesn’t have a disease, isn’t that better information to go by than by probabilistic information about the prospective donor’s population? I’m doubtful of whether the issue here is the logistical requirements of running tests, given the value of finding organ matches. I’m also doubtful of whether the concern could be of an unknown disease flying under the radar, as this would be a risk for any donor and, more importantly, this is only a potential risk whereas the potential organ recipient is known to need an organ and that failure to receive this organ in a timely fashion will carry definite averse consequences (e.g., death). I am curious to see what the reasons for this new policy are and how this whole issue plays out.

(Hat tip: Ponderation)

Addendum: It has been brought to my attention that a flaw of testing is that many diseases aren’t detectable until years after their contraction. Thus, relying on testing to determine whether blood or an organ is clean is by no means an assured way to determine whether or not a known disease is present. Thus, using statistically supported heuristics such as sexual orientation could be a valid practice. One could however still argue that sexual conduct is more important than sexual orientation and should be taken into account as well. The argument could be made that it would not be fair or prudent to accept organs from a straight person who was far more sexually active than a sexually active gay male.

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7 Responses to “Sexually active gay men no longer allowed to donate organs in Canada”
  1. whocares says:

    who cares? homosexuality is the biggest con job of the 21st century. why not just and shut up? (they) r not ethnic minorites — they r the MAJORITY (disproportionately white and stingy). reminds one of another old white male dominated party from the 30s-40s … hmmmm

  2. chuynh says:

    The opponents the permanent deferral of men who have sex with men (MSM) in organ donation and blood donation are wrongfully focused on the rights of the donor. What should be the focus of the debate are the rights of the recipient. As a recipient of blood or organs you would expect that all measures are taken to reduce the likelihood of TTDs (transfusion transmitted disease) and TIDs (transplant infectious diseases), this should include the omission of donors who perform high risk behaviours regardless of lawfulness. The fact that Canada Blood Services, Hemi-Quebec and Health Canada defer MSM as donors shows that they are taking precautions in making sure that our blood and organ supply remains as close to possible disease free.

    Some argue that the process of self-reported interview is obsolete since all blood and organs are tested anyways and that serological testing has advanced greatly in its ability to find infected blood and organs. But in reality early infections are still relatively hard to detect even using the latest in serological testing, and of course false-negatives still do occur although rarely. Some TTDs are not tested for and mostly rely on the self-report for detection (eg. malaria.) Also in times of emergency serological testing is simply not possible and therefore high risk blood should not be part of the supply.

    I do agree the current method of screening does reduce immensely the likelihood of disease transmission, but is this minuscule risk outweighed by the prospect of easing the difficulty of finding and recruiting donors? Some, even many recipients would say yes. The allowance of a one-year deferral for MSM in blood donations has been estimated to increase the number of donors by one percent, small but not insignificant.

    Yet remember, CBS and Health Canada are responsible for the cleanest supply of blood and organs possible to recipients. It is good policy that they would impose constraints on donor populations who engage in high risk activity regardless of lawfulness, if these constraints mitigate the possibility of TTDs and TIDs, and that the burden of these constraints are reasonable on the population. Above all, the rights of the recipient should always supersede the rights of the donor; it is they after all who assume the risk in blood transfusions and organ transplantations.

    Germain, M., Sher, G. Men who have sex with men and blood donation: is it time to change our deferral critiera? J Int Assoc Physicians AIDS Care (ChicIII):1, 89, 2002

  3. ronbrown says:

    Chuynk:

    Thanks for posting. This is good information to have. I was not aware of the extent of the fallibility of testing. I was definitely aware that it wasn’t perfect—how can you detect an unknown disease, for instance. But if the fallibility is so great as to make the risk outweigh the reward, then I would certainly take your position.

    I fully agree that the recipient is to take priority over the donor.

    I will keep on eye out for statements from Health Canada on this. If you or anyone else comes across a relevant statement, feel free to post it or send it to me at theframe problem (at) live (dot) ca.

  4. laurap says:

    Don’t you think that if a disease is essentially hibernating in donated tissue, and if it is infected with whatever virus or condition it will show up YEARS later, that the poor person who will die without the organ in question might want to take the chance that their life will be extend for however long the new organ lasts? Donated tissue doesn’t come with a warranty, even well match tissue requires a lifetime of anti-rejection meds.

    Unlike blood, we cannot bank organs for later use and there is not a line up of people willing to give lungs and kidneys to strangers.

    It is a thinly veiled fear based policy based on a negative stereotype. While we’re asking recipients permission to have the organs of a “high risk” gay, pireced, tattoed, sexually active male, why not screen out Aborignials (type II diabetes) and Africian Americans (heart disease). This could get ridiculous and offensive pretty quickly…and if the slope is slippery, there is a problem.

  5. Robert says:

    HIV and Hepatitis B and C are detectable within 10 days after infection using NAT testing.

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  2. […] con job of the 21st century? January 10, 2008 — ronbrown In response to my post on sexually active gay men no longer being able to donate organs in Canada, a reader by the name of whocares had this to say in the comment […]



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