Politicians are bracing for a debate about a proposed law that could make Ontario the first province in Canada to allow hospitals to harvest life-saving organs from dead or dying patients who have not made their final wishes known.

New Democrat Peter Kormos plans to introduce a private member's bill Thursday. If it is passed by the legislature the law would establish so-called presumed consent rules, making donations automatic unless a patient has already declined permission.

Kormos said the idea is to close the gulf between the relatively tiny number of organs that become available in Ontario each year and the 4,000 people across Canada who are waiting for a life-saving transplant.

We wouldn't think of throwing out an appliance that we were upgrading in our house … We would take either to Good Will or The Salvation Army," Kormos said Thursday. "Why are we burying or burning good organs every day?"

Kormos noted that thousands of people died every year while on waiting lists for organ transplants.

The bill is being reintroduced after it died on the order paper last year. If passed, it would effectively reverse the current system that requires donors to sign an organ donor card and have it with them in order to allow doctors to harvest their organs.

Instead, consent to harvest organs would be presumed unless the potential donor registers their objection with the province. A database would allow emergency personnel to quickly determine whether a fatally injured or ill person has withdrawn their consent.

"It really is all about changing the culture, changing the perspective, changing the attitudes about organ donation," Kormos said.

"When we're dead, we're dead. I understand that people may have objections to their organs being used. I say, 'God bless.' (But) let those people register their objections."

Private member's bills rarely get passed by the legislature. The bill would need to survive several votes before becoming law.

But Kormos' bill is getting attention from the governing Liberals. Health Minister George Smitherman believes it will spark a national debate and says he supports the proposed law for that reason.

"The reality is in Ontario people are dying because very, very good quality organs are not being made available to keep those people alive," Smitherman said.

"There obviously needs to be a public discussion about this, and that's why I'm supportive of the bill at least for that reason ... (but) I don't think everybody's ready for that."

Polling done by Ontario's organ donation agency, Trillium Gift of Life Network, shows Ontarians are divided on the issue, said CEO Frank Markel, who opposes the idea.

"I'm not sure Ontario as a society is ready for the switch," he said. "These ideas take time to gain public acceptance."

Ontario isn't the first province to grapple with the issue: Canadians on transplant waiting lists in Alberta, Manitoba and Quebec have, in recent years, asked their governments to make presumed consent the law of the land, but it has never taken root.

George Marcello, 50, is a two-time liver transplant recipient who says lives like his are depending on Kormos' bill being passed into law.

"We can't give up on this. We need to really get on top of this issue," Marcello said.

He noted that more than 20 European countries - Portugal, Italy, France, Switzerland, and Greece among them - have made the change and significantly improved organ donation levels.

In Spain, where a similar plan has been in place for 20 years, about 93 per cent of patients on waiting lists get transplants. In Canada, the transplant rate is only a third of that, Marcello said.

While the idea has taken hold in Europe, it hasn't been seen in North America as the best way to improve donation rates, Markel said.

"In my view, presumed consent by itself is not a panacea that will significantly increase organ donation immediately," he said.

"By itself, it's not a cure."

Even in countries where there is such a law, families are still consulted by physicians and decisions made at the time of death, he said.

Effective measures to boost donations include helping people make these decisions in advance, and teaching physicians how to effectively talk with families in a time of crisis, Markel said.

Kormos wants the government to support his bill "to leave a legacy that will save thousands of lives and that will provide leadership for the rest of Canada."

Smitherman said the day may soon come when presumed consent becomes necessary. "I do think that we have to prepare ourselves for that."

Because the legislation would allow patients to opt out of donating, there's no obvious reason why it would run afoul of the Charter of Rights, said Toronto lawyer Clayton Ruby, who's no stranger to constitutional challenges.

"People who care about it will know (they can opt out), but the vast majority of people are quite open to it and don't care," Ruby said.

Under the current system, however, a signed donor card isn't a legally binding document, and the final legal decision in the end rests with the deceased person's family, he added.

With files from CTV's Austin Delaney and The Canadian Press.