Online user comments responding to deemed consent organ donor legislation in Nova Scotia: a divided public or a few loud voices?

BackgroundThe Canadian province of Nova Scotia recently became the first jurisdiction in North America to pass deemed consent organ donation legislation. This change in legislation generated substantial online discussion, which we analyzed to provide insights on public perception. MethodsWe performed directed content analysis on 2663 user-generated comments appearing on two widely-shared Canadian Broadcasting Company (CBC) articles published online in April 2019. We determined levels of support and opposition in comments and described the specific rhetoric used for doing so. We also performed one-way ANOVA and Pearson chi-square tests to determine how the comments were being received and engaged by other users. ResultsA range of commentary was present in both support and opposition to the changes in legislation. There were more negative than positive comments, and negative commentary generated more replies. Positive comments were received more positively by other users, while negative comments were received more negatively. The total sum of negative comments was greatly influenced by a small number of very active participants. Negative commentary focused more on broad concepts and principles related to government, power, and individual rights rather than specific issues in the Nova Scotian context. Substantial issues of trust in the government and healthcare system were evident. ConclusionsThere were strong positive and negative sentiments expressed in the comments, but the total sum of negativity in the comments was significantly influenced by a small number of commentators. Analysis on the presumed consent concerns can be helpful to inform public outreach efforts. Implication StatementThis research is the first to examine the robust online commentary regarding reactions to Nova Scotias recently-passed deemed consent organ donation law. Our analysis provides extensive detail on the commentary in favour and in opposition to the new law, which has relevance for understanding public perception and designing public outreach.