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According to a study by the Canadian Medical Association Journal published in January, the number of organ donors who die by euthanasia in Quebec has risen from 4.9% (8 out of 164 donors) in 2018 to 14% (24 out of 171 donors) in 2022. While organ donation in such circumstances has been possible since 2015, a decisive new step was taken in 2018.
Since then, Transplant Québec, which coordinates the organ donation process, has been encouraging doctors to talk about organ donation to patients who have opted for euthanasia and who do not have metastatic cancer.
This development raises questions about the confusion that is developing around these two practices, which have completely different, if not irreconcilable, moral values. Little by little, the altruism of organ donation ends up masking the serious attack on the life and dignity of the person being euthanised. Far from being alarmed by this utilitarian shift, Dr Matthew Weiss, medical director of organ donation at Transplant Québec and author of the study, would like to increase information and improve the conditions for organ donation after euthanasia. According to him, around 10% of people who request euthanasia (“Aide Médicale à Mourir" – Medical Aid In Dying - in Quebec) would be eligible to donate. The study also highlights the correlation between euthanasia and organ donation. The number of patients euthanised rose from 968 between 2017 and 2018 to 3,663 between 2021 and 2022.
The average age of donors after euthanasia is 60, and most are men. The most common diagnosis in this population is neurodegenerative disorders. In this context, it is difficult not to question a patient's real autonomy when faced with a doctor's proposal to donate his or her organs. Dr Weiss, quoted in the press, emphasises "the positive impact that a decision to donate organs can have on a patient at the end of life". But in these circumstances, how can we be sure that organ donation and the decision to euthanise are independent? The possibility of organ donation after euthanasia could in fact constitute an indirect incentive to euthanasia, or even a pressure in a context of organ shortage.
The Belgian medical profession is more cautious about the spontaneous mention of organ donation by doctors in the context of euthanasia: despite legislation based on presumed consent to organ donation, in practice the request to combine euthanasia with organ removal must clearly always come from the patient.
Further information: IEB dossier: Organ donation after euthanasia: ethically compatible?