Canada has approximately thirty-three million inhabitants, spread over nine million square kilometres, and there are two official languages: French and English. There is a Canadian federal government as well as ten provincial and three territorial governments which are in charge of local affairs. Canada has many First Nations populations; it is multi-cultural and multi-lingual, particularly in large cities such as Vancouver, Montreal and Toronto, reflecting extensive immigration of peoples from many parts of the world. Universal access to publicly insured healthcare is funded from general taxation, in accordance with the Canada Health Act 1984. This federal Act influences provincial healthcare insurance plans nationally by promising to pay out if the provinces and territories meet a number of requirements. The administration and delivery of healthcare is carried out by each province and territory, producing variation in services across the country.

Canada has an opt-in system of organ donation. In 2007, 2,153 transplants were performed in Canada, and the country recorded a deceased organ donation rate of 14.7 per million population (pmp) in 2008. There is a significant shortfall in the availability of organs for transplantation, with variation between the provinces. In 2008, 4,380 Canadians waited for a transplant, 2,083 received a transplant and 215 died waiting (see Table 12.1 below).

Organ transplantation is administered provincially, with limited national regulatory authority. The federal government's health agency, Health Canada, is empowered to require registration and to inspect Organ Procurement Organizations (OPOs) and living donor transplantation programmes.