In 2017, Canadian Blood Services in collaboration with the Canadian Critical Care Society, the Canadian Society of Transplantation, and the Canadian Association of Critical Care Nurses hosted a two-day consensus forum in response to patient-initiated and practitioner requests for guidance on organ and tissue donation after medical assistance in dying (MAiD). Medical, legal and ethical experts, as well as patient and family partners, were brought together and developed guidance to help organ and tissue donation organizations, administrators, policy makers, and health care teams navigate clinical issues surrounding organ and tissue donation by patients who choose to donate their organs and tissues after MAiD or the withdrawal of life-sustaining measures (WLSM).
The 2019 publication, Organ and Tissue Donation for Medical Assistance in Dying and Other Conscious Competent Patients: Expert Guidance for Policy, makes several key recommendations, including:
The Supreme Court of Canada decriminalized MAiD in 2015, and Parliament passed Bill C-14 to outline the procedures and eligibility criteria for MAiD in Canada in June, 2016. In October 2020, the Quebec Superior Court found that one of the eligibility criteria outlined in Bill C-14 was incompatible with the original decision of the Supreme Court of Canada. Accordingly, the Minister of Justice and Attorney General of Canada introduced Bill C-7, which proposed a series of changes to the Criminal Code’s provisions on MAiD to align with this decision, and to address some additional concerns with the procedures outlined in the original Bill C-14. The proposed changes follow extensive consultations with Canadians, experts, practitioners, stakeholders, Indigenous groups, provinces and territories, and an online questionnaire that received over 300,000 responses.
In summary, the Bill proposed the following Criminal Code amendments to the MAiD regime:
In response to the legislation changes outlined above, Canadian Blood Services assembled a group of medical, legal and ethical experts, as well as patient and family partners, to examine the legislation changes and it s impact on organ and tissue donation practices. In particular, the group will examine the potential impacts of advance consent and loss of capacity prior to MAiD and donation. The group will not focus on issues surrounding eligibility to MAiD. The group will also use this opportunity to examine other emerging issues related to MAiD and donation, including directed donation, donation following MAiD at home, national data collection, knowledge gaps and future research questions. Based on the expert deliberations, the current guidance for policy will be updated, as necessary.
Stakeholders came together for a virtual forum in June of 2021. A report is currently in publication.
A second meeting took place in April 2022.
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Downar J, Shemie SD, Gillrie C. Deceased organ and tissue donation after medical assistance in dying and other conscious and competent donors: guidance for policy. CMAJ 2019 June 3;191:E604-13. doi: 10.1503/cmaj.181648