Medically assisted deaths prove a growing boon to organ donation in Ontario
Medically assisted deaths prove a growing boon to organ donation in Ontario
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Get the latest from Bruce Deachman straight to your inbox Published Jan 06, 2020  •  6 minute read   You can save this article by registering for free here. Or sign-in if you have an account.Montrealers Nicole Gladu and Jean Truchon attend a news conference last September, where they gave their reaction to a Quebec judge overturning parts of provincial and federal laws on medically assisted dying. Canadian who seek MAiD are increasingly also donating their organs and tissues. Photo by Graham Hughes /THE CANADIAN PRESSOntarians who opt for medically assisted deaths (MAiD) are increasingly saving or improving other people’s lives by also including organ and tissue donation as part of their final wishes.In the first 11 months of 2019, MAiD patients in the province accounted for 18 organ and 95 tissue donors, a 14 per cent increase over 2018 and a 109 per cent increase over 2017. (Figures for December 2019 are not yet available.)This advertisement has not loaded yet, but your article continues below.THIS CONTENT IS RESERVED FOR SUBSCRIBERS ONLYSubscribe now to read the latest news in your city and across Canada.Exclusive articles from Elizabeth Payne, David Pugliese, Andrew Duffy, Bruce Deachman and others. Plus, food reviews and event listings in the weekly newsletter, Ottawa, Out of Office.Unlimited online access to Ottawa Citizen and 15 news sites with one account.Ottawa Citizen ePaper, an electronic replica of the print edition to view on any device, share and comment on.Daily puzzles, including the New York Times Crossword.Support local journalism.SUBSCRIBE TO UNLOCK MORE ARTICLESSubscribe now to read the latest news in your city and across Canada.Exclusive articles from Elizabeth Payne, David Pugliese, Andrew Duffy, Bruce Deachman and others. Plus, food reviews and event listings in the weekly newsletter, Ottawa, Out of Office.Unlimited online access to Ottawa Citizen and 15 news sites with one account.Ottawa Citizen ePaper, an electronic replica of the print edition to view on any device, share and comment on.Daily puzzles, including the New York Times Crossword.Support local journalism.REGISTER / SIGN IN TO UNLOCK MORE ARTICLESCreate an account or sign in to continue with your reading experience.Access articles from across Canada with one account.Share your thoughts and join the conversation in the comments.Enjoy additional articles per month.Get email updates from your favourite authors.THIS ARTICLE IS FREE TO READ REGISTER TO UNLOCK.Create an account or sign in to continue with your reading experience.Access articles from across Canada with one accountShare your thoughts and join the conversation in the commentsEnjoy additional articles per monthGet email updates from your favourite authorsSign In or Create an AccountAccording to Trillium Gift of Life Network, which oversees organ and tissue donation in Ontario, the 113 MAiD-related donations in 2019 accounted for five per cent of overall donations in Ontario, a share that has also been increasing. In 2018, MAiD-related donations made up 3.6 per cent of the province’s total donations, and in 2017 just 2.1 per cent.“The decision to pursue MAiD is totally separate from the decision to donate organs,” cautions Ronnie Gavsie, Trillium’s chief executive officer, “but we do want patients to have their last will carried out.”This relatively new source of organs and tissues is significant in that Ontario’s waiting list for organs typically hovers around 1,600 without any great headway made to eliminate that number. While 90 per cent of Canadians reportedly support organ donation, only 34 per cent of Ontarians have registered online, and the growth rate in registered donors has declined for three consecutive years.Canada decriminalized medically assisted death in 2016, and Ontario, through Trillium, immediately moved to the forefront of organ and tissue donation through MAiD, becoming the first jurisdiction in the world to proactively reach out to those who had been approved for assisted death to discuss donation. When a death is imminent, whether through a hospital or MAiD, Trillium must by law be notified.The Ottawa Citizen’s best journalism, delivered directly to your inbox by 7 p.m. on weekdays.By signing up you consent to receive the above newsletter from Postmedia Network Inc.A welcome email is on its way. If you don't see it, please check your junk folder.The next issue of Evening Update will soon be in your inbox.We encountered an issue signing you up. Please try againThis advertisement has not loaded yet, but your article continues below.“And, as part of high-quality end-of life care, we make sure that all patients and families are provided with the information they need and the opportunity to make a decision on whether they wish to make a donation,” Gavsie says. “That just follows the logical protocol under the law and the humane approach for those who are undergoing medical assistance in dying. And it’s the right thing to do for those on the wait list.”Regulations in some other jurisdictions where euthanasia or assisted suicide is permitted, such as Belgium and Netherlands, only allow organ donation at the patient’s initiation. In Switzerland and the U.S. states Oregon, Washington, Vermont and Montana, where assisted suicide is legal, subsequent organ donation is not possible. Quebec, which initially allowed only patient-initiated donation, now allows Transplant Québec to initiate donation discussions with patients who have been accepted for MAiD.There are factors, however, that stack against MAiD patients becoming donors. Those with cancer, for example, which according to a 2018 Canadian Blood Services report accounts for 57 per cent of MAiD deaths in Canada, cannot donate organs. Additionally, current laws stipulate that organ donors must die in a hospital, whereas many MAiD patients choose to die in their homes. (Tissues, however, such as eyes, heart valves, bone tendons and skin, can be recovered following home deaths.)This advertisement has not loaded yet, but your article continues below.But even those considerations are shifting. According to Dr. Andrew Healey, Trillium’s chief medical officer of donations, many MAiD patients are deciding that organ donation is a higher priority than choosing the location of their death.“The striking thing about patients who have medical assistance in dying is that they have a very clear vision about what they want, and they have the capacity to make their own decisions. We want people to hear about the opportunities they have and then make the right choice for them. There are several patients we’ve spoken to who had initially planned to die at home, but that wasn’t as important to them as helping other people.”Additionally, Healey notes, protocols are under consideration whereby lungs, which can remain viable far longer than other organs after removal, could still be retrieved following MAiD deaths at home.Dr. Sam Shemie, Canadian Blood Services’ medical adviser for deceased donations, notes, too, that MAiD donors bring first-person informed consent, releasing their families from having to make such decisions at possibly the worst emotional time, when a loved one might be comatose following a tragic illness or accident.This advertisement has not loaded yet, but your article continues below.“With MAiD, it’s very different,” Shemie says. “These patients have terrible diseases like amyotrophic lateral sclerosis or multiple sclerosis, but they are conscious and competent, meaning they are able to make decisions on their own behalf as part of their own autonomy.”MAiD donations also typically provide more time for testing donor organs and better matching with recipients.MAiD, and its subsequent related organ donation, recently received a potential boost in the courts, when Quebec’s Superior Court ruled last September that parts of the laws governing assisted death were unconstitutional.The decision followed a lawsuit by Montrealers Jean Truchon and Nicole Gladu, who have incurable degenerative illnesses and were refused MAiD. In particular, they challenged the Criminal Code restriction that natural death be “reasonable foreseeable” before being eligible for assisted death and the portion of Quebec’s Bill 52 that said people must “be at the end of life.” The court decision gave both governments, neither of which appealed the decision, six months to amend their laws.This advertisement has not loaded yet, but your article continues below.Others have urged changes to the current ban on advance requests, which leaves open the possibility that a patient with Alzheimer’s disease, for example, might be incapable of reaffirming consent at the time of the MAiD procedure.According to Shemie, many groups advocating organ donation were initially reluctant to step into the already polarized MAiD issue.“From a national lens, we said, ‘Boy, to mix organ donation into this is just volatile. We really should stay away from it,’” he recalls. “But the problem was that patients were asking for it. And so we said that, if that’s what patients want, if that’s what they’re asking for, particularly in the situation where they’re making independent, autonomous decisions about their own future, then we need to provide guidance to the community about how to do this properly: medically, legally, ethically.”Heather Janack, who worked in the Attorney General of Ontario’s office that helped to write the MAiD laws, was one patient who saw the issue from various sides.On dialysis for 43 years, Janack died last July, a month shy of her 62nd birthday. Facing complications she knew would end her life, the Cobourg resident opted for a medically assisted death.This advertisement has not loaded yet, but your article continues below.She also elected to become an organ donor, a decision she said brought her a great deal of happiness.“My choice for MAiD came first,” she said in an interview, “but the thought and opportunity to potentially save the life of another was right behind it.“It has always been a parallel thought process for me. I thought the knowledge of having full autonomy by way of MAiD was comforting, but, when the possibility of organ donation was added to it, the sense of elation is the only appropriate word for me. It is so exciting to know that I have the potential to alleviate the suffering of someone on a wait list.”According to Trillium’s Gavsie, Janack’s story is not atypical of MAiD patients who choose to become donors.“Not only are they dying with dignity and at a time of their choice, but they’re leaving a legacy.”ALSO IN THE NEWSJapanese woman turns 117 years old, extends record as world’s oldest personWilliams: Flu shot goes long way to reducing impact of the virusOC Transpo to conduct safety review of Transitway, stations   Canada     Celebrity      Local News      Food      Local News  Notice for the Postmedia NetworkThis website uses cookies to personalize your content (including ads), and allows us to analyze our traffic. Read more about cookies here. By continuing to use our site, you agree to our Terms of Use and Privacy Policy.