Trillium Gift of Life Network Act

Ontario followed the lead of the Uniform Law Conference of Canada, adopting the 1971 Uniform Human Tissue Act. In the 1980s the discussion in Ontario’s legislature was focused on consent and developing a national registry to increase the rate of donation.[i] Then, in the 1990s and 2000s, conversation was focused on program and policy changes that would assist in increasing organ donations. This led to the creation of the Trillium Gift of Life Network in 2000, which would become responsible for planning, coordinating and supporting organ and tissue donation across Ontario.[ii] The amendments made in 2000 included the exclusion of spermatozoa, ovum, embryo, and foetus, from the definition of “tissue”, however, there was no discussion of why the change was made.[iii]

As for the prohibition on sale that has not changed since the 1970s. The prohibition, as written, applies to “any body or part or parts thereof”, other than blood, suggesting that even those tissues excluded from the definition of “tissue” would be prohibited from sale under the Trillium Gift of Life Network Act. However, this is arguable as the legislation is certainly not clear on whether the exempt tissues are included in the prohibition.

Voluntary Blood Donation Act & Its Exemptions

Given the exemption to blood and blood products from the prohibition on sale, in 2014 a for-profit plasma clinic was able to establish itself in Ontario. The establishment of the clinic caused considerable controversy, and eventually led to Ontario becoming the first province to institute a Voluntary Blood Donation Act.

The majority of those opposed to paid plasma donations cite the Krever report as the key reason for needing to maintain a voluntary system. Outside the Krever report, other arguments against paid plasma donation included the concern that allowing a for-profit plasma clinic will erode the non-profit framework of the Canadian health care system, a for-profit clinic will take advantage of those who are financially disadvantaged and will negatively impact the voluntary blood donation system. Key arguments raised by those in favour of allowing the paid plasma donations include that Canadians are already paying other countries for plasma (where those countries allow paid donations), that there is a shortage of plasma and that will only grow with the aging population, and allowing paid plasma donations promotes the best interests of patients who need treatments derived from plasma.[iv]

While Ontario's Voluntary Blood Donations Act (similar to British Columbia’s legislation) prohibits the sale of blood and blood constituents, it includes provisions for Canadian Blood Services (CBS) and its agents, legally permitting them to operate for-profit clinics and pay individuals for their blood donations. 

In 2022, CBS entered into a 15-year agreement with Grifols, a Spanish pharmaceutical company, with the objective of establishing additional pay-for-plasma collection clinics nationwide. Under this agreement, Grifols acts as an agent of CBS, which enables Grifols to legally open for-profit plasma clinics, notwithstanding Ontario's general prohibition on the sale of blood and blood constituents. In 2022, Grifols announced plans to open its first Ontario locations in Whitby, Cambridge, and Hamilton by late 2024 and into 2025. 

References

[i] See Legislative Assembly of Ontario, Ontario Hansard, “Bill 45, Human Tissue Gift Amendment Act”, 2nd reading, 32:3 (09 June 1983) (Mr Van Horne); also see Legislative Assembly of Ontario, Ontario Hansard “Organ Donations”, 34:1 (14 April 1988) (Mr Eves).

[ii] See Legislative Assembly of Ontario, Ontario Hansard, “Bill 19, Human Tissue Gift Amendment Act, 1992”, 2nd reading, 35:2 (04 June 1992); also see Legislative Assembly of Ontario, Official Report of Debates (Hansard), “Bill 142, Human Tissue Gift Amendment Act (Trillium Gift of Life Network), 2000”, 2nd reading, 37:1 (20 December 2000).

[iii] Ontario Premiers Advisory Board on Organ and Tissue Donation, A plan for change and action: Organ and tissue donation in Ontario, by Don Cherry (2000).

[iv] See Legislative Assembly of Ontario, Official Report of Debates (Hansard), “Blood Donation”, 40:2, no 116 (24 March 2014) at 6024; Legislative Assembly of Ontario, Official Report of Debates (Hansard), “Bill 178, Voluntary Blood Donations Act, 2014”, 2nd reading, 40:2, no 123 (03 April 2014) at 6434; Legislative Assembly of Ontario, Official Report of Debates (Hansard), “Bill 21, Safeguarding Health Care Integrity Act, 2014”, 2nd reading, 41:1, no 25 (05 November 2014) at 1022.