EDMONTON -- Eight out of 10 Canadians who support organ donation say they are willing to give the gift – but only three in 10 actually sign up.

It's a point researchers say is particularly useful in recruiting donors.

For example, more are willing to register when asked, "If you needed a transplant, would you have one?"

That's according to research by behavioral scientist and marketing professor Nicole Robitaille at Queen's University Smith School of Business, who studies the above discrepancy.

It's called the intention-action gap.

"A lot of times we have great intentions to eat healthier, save more money, and we just don’t follow through," Robitaille explained.

The same thing seems to happen with organ donation.

Robitaille's team studies not only the gap, but how to close it – particularly relevant research during Organ Donation Awareness week one year into the pandemic, when transplants have dropped in Alberta by an estimated 12 per cent.

Norman Kneteman, Edmonton medical zone's chief for transplantation, says the decrease is closer to 20 per cent for certain organs: kidneys, the liver, and lungs.

"The pressures of COVID on the hospital system, for various reasons, seemed to have resulted in a significant drop in donation, and that drop in donation reflects in a decrease in the number of transplants we can carry out."


According to Canadian Blood Services, a person is six times more likely to need a transplant than they are likely to become a donor.

Informing the public of that fact is a very effective method of seeing people sign their intent into an official registry, Robitaille has found.

It's reciprocal altruism, she said: "You think, 'I should help others if I am willing to get one.'"

Including "If you needed a transplant, would you get one?" nudges on sign-up forms has doubled the rate of registration, she said.

Posing another question – How would you feel if you or a loved one needed a transplant and couldn't get one? – during license renewals is slightly less effective but still successful.

The other strategy Robitaille's team has focused on is simplifying the process for would-be donors, starting with the form.

Ontario tested giving people a donor form while in wait lines at a registry, rather than in the middle off their license renewal.

In 2020, Alberta made changes so that donors could register online with their health card.

"Both things matter," Robitaille. "Just giving the information is not enough."


"If there was one easy answer as to how to convert that into 90 per cent donation," Kneteman said, "we would certainly be all in to do it."

He's watching closely the Nova Scotia "experiment" of moving to an opt-out system of presumed consent.

Whereas Albertans opt in, Nova Scotians are the only Canadians who have to remove themselves from a donor list.

"It's the model that has been utilized in Europe for several decades, and there is no question that donation rates in that country are substantially higher than they are in Canada," he said.

The benefit, Robitaille explained, was that donor lists have expanded greatly even if the number of donations do not (final permission rests with families). Opposition is founded in the ethical concerns of assuming residents' consent.

A private member proposed Alberta moving to an opt-out system in 2019, but the bill failed to be passed before the end of the 30th legislature session.

For now, Robitaille suggests improving the systems that exist until data is available from Nova Scotia.

"It allows more freedom of choice, it doesn’t pose new legislation, and if we can improve these new systems that we found in our research, then we can increase registrations without having all those ethical concerns about an opt-out system."

Both Robitaille and Kneteman encouraged Albertans to consider signing up.

In 2020, 395 people received a transplant.

It is estimated one donor can save as many as eight lives.

With files from CTV News Edmonton's Chelan Skulski