Online perspectives of deemed consent organ donation legislation in Nova Scotia, Canada: a thematic and content analysis of commentary in facebook groups
Alessandro Marcon1, Darren N Wagner1, Carly Giles1, Cynthia Isenor2.
1Health Law Institute, Faculty of Law, University of Alberta, Edmonton, AB, Canada; 2Nova Scotia Health , Halifax, NS, Canada
Background: The Canadian province of Nova Scotia recently became the first jurisdiction in North America to implement deemed consent organ donation legislation. Changing the consent models constituted one aspect of a larger provincial program to increase organ and tissue donation and transplantation rates. Deemed consent legislation can be controversial among the public, and public participation is integral to the successful implementation of the program.
Objective: Social media constitutes key spaces where people express opinions and discuss topics, and social media discourse can influence public perceptions. This project examined how the public in Nova Scotia were responding to the legislative changes in Facebook groups.
Methods: This project analyzed 2,337 comments on 26 relevant posts in 12 different public Nova Scotia-based Facebook groups. We conducted thematic and content analysis on the comments to determine how the public was responding to the legislative changes and how the participants interacted with one another in the discussions.
Results: Our thematic analysis revealed principle themes which supported and critiqued the legislation, which raised specific issues, and which reflected on the topic from a neutral perspective. Subthemes showed individuals presenting perspectives through a variety of themes which included compassion, anger, frustration, mistrust, and a range of argumentative tactics. Comments included personal narratives, beliefs about government, altruism, autonomy, misinformation, and reflections on religion and death. Content analysis revealed that Facebook users react to popular comments with “likes” more so than other reactions. Comments with the most reactions included both negative and positive perspectives about the legislation. Personal donation and transplantation success stories as well as attempts to correct misinformation were some of the most “liked” positive comments.
Conclusions: The findings provide key insights into Nova Scotian perspectives on deemed consent legislation as well as organ donation and transplantation broadly. The insights derived from this analysis can contribute to public understanding, policy creation, and public outreach efforts that might take place in other jurisdictions considering the enactment of similar legislation.
The authors thank and acknowledge Health Canada, Genome Canada, Genome Alberta, and the Canadian Institutes for Health Research for their generous support of Legislative Strategies to Improve Deceased Organ Donation in Canada: A Special Focus on Evaluating the Impact of Opt-Out Legislation in Canada LEADDeR and Precision Medicine CanPREVENT AMR: Applying Precision Medicine Technologies in Canada to Prevent Antibody Mediated Rejection and Premature Kidney Transplant Loss.
