Are MAiD organ donors really dead when their organs are harvested? Waiting five minutes after the heart stops may not be long enough

Caryn Lipson

September 30, 2024

This article reveals how MAiD donors die in reality. It follows from "Are organ donors dead when their organs are harvested? 'If you’re really dead, then no organs can be extracted'." If you have not read the first article in the series, "White coat euthanasia: A license to kill in the name of care?" please read the preface.

In previous articles, it has been emphasized that organ donation is a driving factor in Canada's medical assistance in dying (MAiD) euthanasia program. This article is the second of two that explore the redefining of death that has allowed for brain death and cardiac death, concepts devised to make organ harvesting and transplants appear legal and moral.

‍MAiD and the "dead donor" rule

Veteran ER physician and award-winning medical reporter, Dr. Brian Goldman, in an article for CBC News, wrote about the possibilities for organ donation by MAiD victims and, therefore, the importance of the “dead donor” rule. The rule was instituted to make sure that MAiD victims' organs are harvested for donation only after they have died; organ harvesting cannot have caused their death. The rule was included in the published guidelines by the Canadian Medical Association in June 2019.

Health professionals have raised concerns that the provision of MAID might affect the timing of organ donation. The guideline states that the so-called "dead donor" rule must always be respected. That means vital organs can be harvested only from a donor who is deceased as the result of MAID. No attempt can be made to harvest organs before the patient is declared dead.

In other words, the act of harvesting organs cannot in any way contribute to or be the cause of the patient's death.

The guideline states that death resulting from medical assistance should be confirmed by a second physician after a 5-minute "no touch" period of continuous observation. During the 5-minute interval, no attempt can be made to harvest donor organs.

The dead donor rule was instituted before the Canadian Medical Association published the guidelines. Real Women Canada wrote about doctors who wanted to do away with the dead donor rule in November 2018 so that organ harvesting could be the cause of death. The impetus for this push was to allow the organs to be as fresh as possible for use in transplant surgery.

The authors argue that since Canada allows physician-assisted suicide, then Canada should also dispense with the dead donor rule i.e. that a patient must be dead before organs are retrieved. This would allow transplant surgeons to have access to fresh organs. This is contrary to normal protocol, which is to wait for several minutes after blood circulation ceases (donations after cardiac arrest) prior to removing organs. But even in this brief space of time, the quality of the organ to be transplanted declines.

The authors of this article argue, therefore, that if organs can be removed from a prospective euthanasia patient while he/she is still alive (provided consent has been given) then the organs would be as fresh as possible. The authors thoughtfully suggest that the patients would be anaesthetized before their organs are removed, to avoid any “discomfort”. In other words, rather than wait for the patient’s heart to stop after a lethal injection has been administered by the physician, as is currently done in the Netherlands and Belgium, the removal of the organs, not the lethal injection, would be the direct cause of death.

An anesthesiologist explains how MAiD donors die

Since MAiD donor organs need to be “as fresh as possible,” they are killed in a process akin to that used for surgical patients under anesthesia, quite different than the procedure that anesthesiologist Dr. Joel Zivot discussed to kill MAiD victims, in general. Dr. Joel Zivot asserted that Canada’s MAiD victims likely drown to death. He reached this conclusion after reviewing 200 autopsies of death row inmates in the U.S. The autopsies revealed that their lungs had filled with fluid and that their other organs failed. These inmates died by lethal injection, and MAiD uses similar protocols and the same drugs.

Transplant anesthesiologist Dr. Claire Middleton discussed the process with Unveil Studios’ Kooman brothers, for their documentary, “Ethics and MAiD organ donation.” She explained the difference between how a patient dies when life-sustaining treatment is withdrawn in order to harvest their organs for transplant versus the cardiac death of a MAiD victim so their organs can be harvested for transplantation (@ about 14:23).

Donation after MAiD and donation after withdrawal of life-sustaining treatment, the timeline might be slightly different but ultimately what happens is the heart stops and then the other organs are harvested. So in this country that would mean that you don't harvest the heart. People have been concerned about the possibility of trying to restart the heart and therefore reverse the dying process. And so, donation after cardiac death or donation after MAiD up until this point has not included donating the heart. (Emphasis added.)

Now which other organs is [sic] suitable, we’ll come back to that in a minute. But in terms of the drugs which cause death in MAiD, because they act very quickly, they're actually going to, like I talked about, relatively protect the organs because death’s going to happen a lot faster than it does after withdrawal of life-sustaining treatment [which can take up to two hours for the person to die].

Donor hearts are thus not harvested, according to Middleton, since the harvesting might appear to be what killed the MAiD donor. However, if other organs have already been harvested, is it possible that not harvesting the heart at the end is simply a matter of optics?

She also explains that anesthesia for surgery and MAiD are similar but the drugs are used in different quantities and everything is reversed after surgery but not after MAiD.

So the drugs that are used for MAiD are very similar to the drugs that are used to induce anesthesia just in very different quantities. And obviously, if I'm planning on inducing anesthesia for a therapeutic surgical procedure I have the wherewithal to maintain ventilation. You know I'll put a breathing tube in, the patient will be on a ventilator, I’ll support the blood pressure as needed, and then all of these things will be reversed at the end of the surgery with MAiD the same kind of drugs are used just in different doses and are not reversed.

Are you dead when your heart stops?

A study published in the journal Resuscitation on September 14, 2023, showed that people who had been revived with CPR remained conscious for up to an hour after their hearts stopped and had clear memories of experiencing death. Becky Upham wrote about the study for Healthline.

. . . {T}he study published earlier this year in the Proceedings of the National Academy of Science provided the strongest evidence to date that some kind of consciousness remains for a short time after the heart stops beating and a person is considered dead.

. . .

“Although doctors have long thought that the brain suffers permanent damage about 10 minutes after the heart stops supplying it with oxygen, our work found that the brain can show signs of electrical recovery long into ongoing CPR,” said senior study author Sam Parnia, MD, PhD, an associate professor in the department of medicine at NYU Langone Health in a press release. (Emphases added.)

. . .

“We were able to also identify the mechanism by which this experience occurs, which is that as the brain shuts down, because of a lack of blood flow in death, the normal braking systems in the brain are removed, known as disinhibition. This enables people to have access to their entire consciousness, or their thoughts, memories, all their emotional states, everything they've ever done, which they relive through the perspective of morality and ethics,” he said.

Is a dead MAiD donor dead?

What are the implications if there is no such thing as a dead MAiD donor, especially in light of the similarities between putting someone under for a surgical procedure and a MAiD death, and the above study which found that the brain continues to function even after the heart has stopped?

How much do we really know about the dying process?
Is a person truly dead after the heart has stopped beating for five minutes, or was that time frame conceived to make it appear that the person has died so that the organs can be harvested when "fresh as possible?"
How long does it take to know that someone has irreversibly died and their brain is no longer functioning at all? Dr. Michael DeVita of the University of Pittsburgh’s Medical Center described a dead person as "cold, stiff, gray, and not breathing,” as The Gold Report quoted him previously.
Can it be reasonably inferred that it is the organ harvesting that kills the donor and not the “cardiac death?” Despite the “dead donor” rule?

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Please check back for the next article in the series, "Profiteering from euthanasia and transplants," when The Gold Report reviews the economics that may be motivating Canada's strong push to kill its citizens and harvest their organs.

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The information contained in this article is for educational and information purposes only and is not intended as health, medical, financial or legal advice. Always consult a physician, lawyer or other qualified professional regarding any questions you may have about a medical condition, health objectives or legal or financial issues. ‍If you are struggling with suicidal thoughts, you can call a qualified free mental health helpline or seek help from a qualified therapist.

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