With nearly 500 British Columbians anxiously awaiting organ transplants, there are new calls to make everyone in the province donors by default.

According to the Kidney Foundation of Canada, only 19 per cent of B.C. residents are registered organ donors. That’s a surprisingly low number considering a poll conducted just last year found 95 per cent of the province’s adults support donation.

The answer, according to some advocates, is the system known as presumed consent.

“It’s the gift of life,” kidney disease survivor Joel Solomon told CTV News, “and there is so much suffering that is unnecessary.”

Solomon made a passionate case for presumed consent at the 2015 Kidney Transplant Summit in Vancouver Friday. The system has already been introduced in dozens of European countries, and Solomon said some of them saw donation rates increase as much as 30 per cent.

Most countries also give people the ability to opt-out, but the idea of automatic enrollment is still controversial in Canada.

For Solomon, the issue boils down to basic human decency.

Solomon was diagnosed with polycystic kidney disease, a genetic condition, in his early 20s. As he aged, his kidney function started to deteriorate, and in 2007 he was told he’d be on dialysis in months if he didn’t find a donor.

“I had watched my father die on dialysis, and I thought if there’s a way to skip that then I want to try,” he said.

Due to his rare blood type, Solomon learned there was an average wait of more than 12 years for a cadaver kidney, so he decided to put out an email plea for a donation to his friends. It was the hardest thing he’d ever written.

Fortunately, his story had a happy ending.

“One of my friends offered me her kidney,” he said. “In November of that year I became the first in my genetic lineage to live through polycystic kidney disease.”

But since his surgery, Solomon’s heard many heartbreaking stories from other kidney disease sufferers who couldn’t bring themselves to ask. It might not be such a problem, if not for the low donation rate in B.C.

The low rate may be partly due to people mistakenly believing they're registered, unaware the province's donor decal system that let people sign up along with their driver's licence or Care Card is no longer valid.

“It’s really surprising how many very well educated people don’t know about this,” Solomon said.

The only way to ensure your organs are donated after you die is to register at the B.C. Transplant website, which boasts that a single donor can save up to eight lives.

Dr. Stephen Beed, an intensive care physician in Halifax who’s a member of the Organ Donation and Tissue Expert Advisory Committee, said the issue of low donor rates is a problem across Canada.

“For a wealthy country with a very well-developed medical system and a population that repeatedly says that they’re supportive of donation, our performance is mediocre at best,” Beed said.

But not everyone believes presumed consent is the answer. Beed said implementing automatic enrollment could do more harm than good by scaring people away from donation.

“This topic generates very strong opinions among I think a small percentage of the population, but that group has not been hesitant to let their voice be heard,” Beed said.

“And unfortunately, it flavours and even takes over the whole argument.”

It could be possible to successfully introduce presumed consent in Canada, Beed added, but for now he’d prefer to see health care providers focus their effort on improving the identification and referral of potential donors.

To become an organ donor or check if you’re already registered, visit the B.C. Transplant website.

With a report from CTV Vancouver’s Mi-Jung Lee