Patients in Canada who decide to end their lives with physician help also contributed to almost half of the world’s documented organ transplants occurring after euthanasia.
Five years ago, patients had to be facing imminent death in order to avail of the procedure. That is not the case anymore.
AltruismCanada has some of the most liberal rules in the world for receiving assisted suicide. The authors of the review noted that clear ethical standards need to be implemented, as there are consent and trust issues to resolve due to “potentially influenceable” patients.
The report noted that altruism could become a motivating factor in ending one’s life. There is “risk that knowing how many people their organs could help, will prevent the MAID patient from feeling absolute freedom to change their mind, right up until the last time they are asked whether they wish to proceed, just before substance administration,” it noted.
Ethical ConcernsOrgan donation after euthanasia “raises some important ethical concerns involving patient autonomy, the link between the request for MAID and the request to donate organs and the increased burden placed on seriously ill MAID patients,” said the report.
The number of people obtaining assisted suicide was up 32.4 percent in 2021 from 2020, according to Health Canada.
Just under half of people chose to have their deaths at home in 2021, roughly 44 percent. There were 12,286 written requests for assisted suicide in 2021, up 27.7 percent from 2020. Of those, 81 percent were provided euthanasia.
MAID at HomeCanada is also leading globally in another area, according to the review. There have been eight documented assisted suicides where the patient had MAID in their homes and were then transported by ambulance to have their organs removed. Five of those occurred in Canada.
In 2022, Canadians learned that people in severe economic or medical crises had been applying to die by assisted suicide because they could not cope with their challenges or pay their bills.
The federal government has said that employee no longer works with the department. It has also said it will delay the plan to expand euthanasia to include people with a mental illness as their only medical condition.
Organ DonationA total of 2,782 organ transplants were performed in Canada in 2021; 78 percent of transplants used deceased donor organs and 21 percent used living donor organs.
Of those organ transplants, 136 came from deceased Canadian donors, making up 6 percent of all transplants in the country, according to the Canadian Institute for Health Information.
Organ donation after euthanasia (ODE) began in 2005 globally, and by 2017 was developed for patients obtaining MAID from home.
“ODE is of increasing importance for donors, representing up to 14 percent of donations after circulatory determination of death,” said the report.
The review noted that organ donation from assisted-suicide patients raised many “unique, ethical and logistical considerations” and had multiple stakeholders, including the patient and family, end-of-life care providers, and organ procurement organizations.
According to the review, in 2020, there were 17,217 assisted suicide deaths globally, which included those who self-administered MAID drugs. Most of the patients had cancer or neurological conditions, said the report.
“I am concerned that people who struggle with a lack of self-esteem and self-worth may be pushed to see this as an opportunity to mean something,” Lemmens told reporters.
The author of the review, Dr. Johannes Mulder, who provides MAID in Zwolle, Netherlands, did not reply by press time, but told reporters “guidelines are necessary and should also be strict” when adding organ donation to assisted suicide.
Organ donation after euthanasia “is an exceptional procedure, presenting legal, ethical, and operational challenges and requiring dedicated guidance that will gain and retain society’s confidence. If protocols are diffuse in their aims or burdened by earlier habits and ways of thinking, quality of care could be compromised and trust lost,” stated the report.
“If a public misperception arises that ODE is aimed at increasing organ procurement, this confidence will be rapidly lost.”