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Organ and tissue donation by those who choose medical assistance in dying: navigating this emerging area

June 3, 2019 (OTTAWA) –  A new publication in CMAJ (Canadian Medical Association Journal) aims to help health care teams navigate clinical issues surrounding organ and tissue donation by patients who choose to donate after medical assistance in dying (MAID) or withdrawal of life-sustaining measures. 

In collaboration with the Canadian Critical Care Society, the Canadian Society of Transplantation, and the Canadian Association of Critical Care Nurses, Canadian Blood Services brought together medical, legal and ethics experts to inform this work, as well as patient partners who brought unique perspectives and thoughtful insight. 

“Canadian Blood Services is proud to have supported the development of this important guidance to help clinicians navigate organ donation for patients who have chosen MAID,” says Amber Appleby, director of organ and tissue donation and transplantation with Canadian Blood Services. 

Deceased organ and tissue donation is a common practice that saves or improves lives worldwide. For the thousands of Canadians who receive a transplant every year, 3 out of 4 transplanted organs come from deceased donors. 

The new publication, Organ and Tissue Donation for Medical Assistance in Dying and Other Conscious Competent Patients: Expert Guidance for Policy, makes key recommendations, including:  

  • Protection for patients – the decision to have MAID or withdrawal of life-sustaining measures must occur before any discussion of organ donation. 

  • Choice – medically suitable conscious competent patients who provide first-person consent to end-of-life procedures should be given the opportunity to donate organs and tissues. 

  • Consent – the patient must be able to provide first-person consent and be able to withdraw consent for MAID or donation at any time. 

  • Donor testing – physicians, transplant teams and other staff should try to minimize the impact and disruption of donating (such as testing) for the patient. 

  • Determination of death – the dead donor must be respected, meaning vital organs can only be removed from deceased donors after determination of death according to accepted criteria. 

  • Conscientious objection – health-care professionals may choose not to participate in MAID or withdrawal of life-sustaining measures, but they should work to support the patient’s wishes to donate. 

To help health care teams, the publication includes an easy-to-reference table with the complete recommendations. 

Read the publication here, or listen to CMAJ’s podcast.  

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