• Kim Wiebe, Lindsay C Wilson, Ken Lotherington, Caitlin Mills, Sam D Shemie, James Downar, and Organ and Tissue Donation After Medical Assistance in Dying – Guidance for Policy forum participants.
• Shared Health Manitoba (Wiebe), Winnipeg, Man.; Canadian Blood Services (Wilson, Lotherington, Mills, Shemie), Ottawa, Ont.; Department of Pediatrics (Shemie), McGill University, Montréal, Que.; Division of Palliative Care (Downar), Department of Medicine, University of Ottawa; Department of Critical Care (Downar), The Ottawa Hospital, Ottawa, Ont. klwiebe@sharedhealthmb.ca.
• CMAJ. 2023 Jun 26; 195 (25): E870E878E870-E878.

BackgroundSince Canadian Blood Services (CBS) developed policy guidance in 2019 for organ and tissue donation after medical assistance in dying (MAiD), the federal government has made changes to legislation related to MAiD. This document provides updated guidance for clinicians, organ donation organizations, end-of-life care experts, MAiD providers and policy-makers on the impact of these changes.MethodsCanadian Blood Services assembled a group of 63 experts from critical care, organ and tissue donation, health care administration, MAiD, bioethics, law and research to review the legislative changes in the Organ and Tissue Donation After Medical Assistance in Dying - Guidance for Policy forum. Two patients who had requested and been found eligible for MAiD and 2 family members of patients who had donated organs after MAiD were also included as participants. In a series of 3 online meetings from June 2021 to April 2022, forum participants addressed a variety of topics in small and large groups. These discussions were informed by a comprehensive scoping review using JBI methodology. We used an adapted form of nominal group technique to develop the recommendations, which were approved by consensus of the participants. Management of competing interests was in accordance with Guideline International Network principles.RecommendationsAlthough many of the recommendations from the guidance developed in 2019 are still relevant, this guidance provides 2 updated recommendations and 8 new recommendations in the following areas: referral to an organ donation organization, consent, directed and conditional donation, MAiD procedures, determination of death, health care professionals and reporting.InterpretationPolicies and practices for organ and tissue donation after MAiD in Canada should align with current Canadian legislation. This updated guidance will help clinicians navigate the medical, legal and ethical challenges that arise when they support patients pursuing donation after MAiD.© 2023 CMA Impact Inc. or its licensors.

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