Canadian doctors push for euthanasia by organ donation.

An ethicist asks: Is the dead donor rule even relevant?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Logan Washburn reported in the Federalist on January 8, 2025 that Canadian doctors are pushing for euthanasia by organ donation.

Currently euthanasia is linked to organ donation in Canada, whereby, people who are approved for being killed by euthanasia are also encouraged to donate their healthy organs. Some Canadian doctors and "ethicists" are pushing for a change in the law to permit euthanasia by organ donation. Washburn reports:

Canadian doctors have suggested killing euthanasia victims by taking their organs, according to multiple reports, whistle blowers, and public talks. Medical freedom advocates are documenting emerging ties between “medical assistance in dying” (MAID) and organ harvesting.

“The best use of my organs, if I’m going to receive a medically assisted death, might be to not first kill me and then retrieve my organs, but to have my mode of death — as we medically consider death now — to be to retrieve my organs,” said Rob Sibbald, an ethicist of the London Health Sciences Centre in Ontario.

Washburn reports that some Canadian physicians are pushing to permit euthanasia by donation.

Other Canadian doctors have publicly embraced “death by donation,” and a study came out earlier this year exploring euthanasia programs such as MAID as a means of organ harvesting. Canada legalized euthanasia in 2016, and since then the number of Canadians using MAID to kill themselves has significantly increased.

Canadian doctors are also challenging the "Dead Donor rule." Allowing euthanasia by organ donation would require a change to the dead donor rule since the donors would be alive. Washburn reports Sibbald as stating:

“But of the possible solutions to our pragmatic issues, we can continue to allow physicians to decide and let the conflict go to the courts.”

“We’re so invested in this dead donor rule,” Sibbald said. “That rule has become so ingrained in the medical community that we hold it out as a foundational principle. … And I think just as likely there are people who question that value now. And I know there’s perhaps not an appetite to go there, but raising the question — is the dead donor rule even relevant?”

He suggested death may not occur at one particular moment in time, and said the “best use” of organs from patients who are “going to receive a medically assisted death” could be to harvest them while the victim is alive.

“If, to meet your definition of the dead donor rule, you have to consider me dead once you’ve first put me under and you have no intention of bringing me back — well then fine, I can accept that if those are my values,” Sibbald said.

Sibbald suggests that doctors may need to ignore the dead donor rule and allow the courts to decide the outcome. Washburn reports:

“None of my previous comments should be taken as a suggestion that physicians should operate outside the bounds of existing legal or professional ethical standards.”

“Rather, I have suggested that in light of legal developments we should take time to consider whether other legal or professional standards are now also in need of update or reconsideration,” Sibbald said.

The argument is that removing organs before euthanasia will enable the best possible organs for the purpose of donation. Washburn continues:

While some MAID recipients “may want to be sure that organ procurement won’t begin before they are declared dead,” others may want “the option of donating as many organs as possible and in the best condition possible,” according to the article.

“Following the dead donor rule could interfere with the ability of these patients to achieve their goal,” the article reads. “In such cases, it may be ethically preferable to procure the patient’s organs in the same way that organs are procured from brain-dead patients (with the use of general anesthesia to ensure the patient’s comfort).”

Sibbald states that euthanasia by organ donation will require an amendment to Canada's criminal code. Canada's euthanasia law defines medical assistance in dying as the administration of a ‘substance’ by a qualified provider. By this definition,” the article noted, “organ retrieval is not an accepted cause of death.”

Even though Canada has become the "top" nation for organ donation after euthanasia, nonetheless in December 2022 there were still 3700 Canadians waiting for an organ donation. Washburn reported:

In Ontario, euthanasia deaths boosted organ donations in 2020. In Quebec, 14 percent of organ donors were MAID victims in 2022. One article in the Canadian Medical Association Journal includes a diagram of the MAID to organ harvesting pipeline. This was from 2019, when euthanasia was only allowed for those with foreseeable deaths. Now, doctors can end the lives of patients with unforeseeable deaths.

Angelina Ireland, who is the Executive Director of the Delta Hospice Society told Washburn:

“It is the ‘Canadian cull’ — a systematic elimination of the weak, sick, old, and vulnerable via the state euthanasia program called MAID,” Ireland said. “The Government has taken the most sacred right from its citizens, the power to kill them.”

Issues concerning euthanasia by organ donation and abandoning the "Dead Donor rule" are not new but Canada's experiment with euthanasia has made these issues more prominent.

One of the problems with legalizing euthanasia, as in Canada, is that the law permits doctors and nurse practitioners to kill their patients. The question then arises: why kill a person by lethal poison first and then remove the healthy organs when removing healthy organs first, is more efficacious and will naturally result in a dead person.

Further to that, the act of euthanasia makes it impossible to transplant the heart or lungs.

Killing begets more killing.

More articles about this topic:

• Euthanasia turning suicidal people into 'Kill and Harvest' natural resource (Link). 
• Let's not get rid of the Dead Donor rule (Link).
• No to Killing for Organs (Link).
• Canada leads the world in organ donation after euthanasia (Link).