TORONTO - Presumed consent provisions when it comes to organ donation makes most people uncomfortable and Ontario should instead focus on, among other things, recruiting living donors to meet the demand, says a report released Thursday.

Although there's an urgent need to help the more than 1,750 Ontario residents awaiting organ donation, doctors should get explicit permission from dying patients before assuming they will donate, the report states.

Under a presumed consent system, everyone in the province would automatically be an organ donor when they die unless they specifically opted out.

"The people who actually make the decision of whether or not (to donate), they weren't very hot on (presumed consent),'' said Ted Boadway, chairman of a citizens panel commissioned by the province to explore the issue.

"People were quite clear. They want their wishes to be respected.''

The panel was unanimously in favour of supporting living donations because they thought it was "one of the highest expressions of altruistic behaviour they could think of,'' Boadway added.

Live donors are those who could provide a kidney or part of a liver to someone in need. The panel recommended such donors be compensated for lost wages, travel, accommodation and child care expenses if they choose to help.

Last year, British Columbia brought in a pilot project that reimburses live donors up to $5,500 for similar expenses.

Health Minister George Smitherman said he was pleased with the recommendations regarding live donors and agreed it's a good solution.

"It's really, really crucial to acknowledge that if we want to get at that really big number of people that are on the waiting list for a transplant ... living donors are the answer,'' Smitherman said.

"The report gives us a particularly strong (push) on that point, to do a more effective job of supporting those who are willing to make such a big commitment to another human being through the gift of an organ.''

The group also endorsed a system requiring people to state their views on organ donation when applying for, or renewing, a driver's licence or health card _ the basis of a private member's bill introduced by an Opposition member.

Boadway said the panel chose not to specifically endorse Conservative critic Frank Klees' bill to avoid making the report too political, but applauded the principle behind the proposed legislation.

The Ontario Medical Association also spoke out in support for the bill, which led Klees to hope the government would pass it.

"This is something that is an administrative measure that is really of no cost, it can be implemented very quickly, we can have it on our application forms by the end of the year,'' he said.

The idea could do a lot of good in forcing people to think about the issue now, rather than at the last second when it's often too late, said Trillium Gift of Life Network president Frank Markel.

"Enough people don't think about this ahead of time and so they find themselves with a sudden loss in their family, they're consumed by grief, all they can think about is their loss,'' he said.

"They can't think beyond that to reach out and help someone else.''

Smitherman said Klees's bill has been helpful in promoting debate about organ donation but added "I doubt it's the whole package'' and that it likely wouldn't win government support.