Organ Donation and Medical Assistance in Dying in Canada

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IntroductionIn June 2016, medical assistance in dying (MAiD) became legal in Canada. This has prompted many to ask whether organ donation following MAiD should be permitted and under what circumstances. Indeed, since the MAiD legislation came into effect, reports indicate that a few individuals have donated organs following medical assistance in dying. This study considers the legal and ethical questions that arising regarding organ donation following MAiD in Canada.MethodsThe authors have engaged in a review of the relevant federal and provincial laws and policies governing MAiD and organ donation. These include the law establishing the conditions under which an individual may undergo MAiD, provincial laws setting out the consent requirements for organ donation and pre-mortem interventions to determine eligibility for organ donation and conscientious objection policies for health care providers. The authors have also reviewed the relevant national and international literature on organ donation following MAiD.ResultsOur study indicates that there are several important legal and ethical questions that must be considered in developing a framework for organ donation following MAiD in Canada. What legal protections are necessary to ensure free and informed consent to organ donation following MAiD? Several concerns arise such as the risk that patients may feel pressured or coerced to consent to organ donation. Potential safeguards to ensure consent is voluntary include precluding physicians and organ procurement organizations from approaching patients to seek their consent for organ donation, separating the decisions concerning MAiD and organ donation, precluding directed donation and ensuring that patients are aware that they can withdraw consent to MAiD and/or organ donation at any time. Other pressing questions include the extent to which health care professionals may exercise a conscientious objection to this practice and whether the recipient of an organ should be informed that an organ was obtained from an individual who underwent MAiD. In addition to domestic legislation, the experience of countries like Belgium and the Netherlands offer important guidance in addressing some of these difficult questions.ConclusionOrgan donation following MAiD has the potential to benefit patients and increase organs available for donation in Canada. This study considers the difficult legal and ethical questions that arise in this context and proposes a framework for organ donation following MAiD in Canada.Reference:1. Criminal Code - R.S.C., 1985, c. C-46 (Section 241).

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