Because the time, place, and means of medically assisted deaths are pre-planned, euthanasia makes it easier than ever before to collect human organs and tissue before they spoil. The Ottawa Citizen reports more than a 100% increase in donations from MAiD patients in Ontario since 2017. But this is not a silver lining to legalized euthanasia, as it might first appear, and as it is being portrayed. It confronts Canadians with difficult ethical questions. To name a few that the medical community has also been grappling with:

How does the possibility of organ donation impact someone’s decision to be euthanized or not? Will the chance to help someone else motivate (or pressure) them to choose MAiD?

Should the person requesting death be able to direct their donations, since they will be of sound mind when making the decision and possibly have friends or family on a transplant list?

Do we have to keep track of which organs are donated via MAiD to inform potential recipients who may be ethically opposed? Would you want to know where the organ or tissue came from, and should you want to know?

These are not easy questions.

“Medical Assistance in Dying” (MAiD) promises “death with dignity.” Organ donation slides easily into this sales pitch – dignity not only for the MAiD recipient, but also for his bodily benefactors. It adds an extra layer to the sense of control felt by a dying person looking toward their legacy.

Last year, a panel of health professionals issued guidelines for dealing with ethical issues related to MAiD and organ donation, which were published in the Canadian Medical Association Journal (CMAJ). Dr James Downar, a leading palliative care expert and major contributor to the guidelines, recommended that the “dead donor” rule – that the donor must have been dead for a minimum number of minutes before organs are harvested – be respected. Otherwise, MAiD techniques could allow doctors to put a patient to sleep, but not quite kill them until the organs have been harvested, in order to get the freshest tissue and organs.

Downar also acknowledged the potential pressure on vulnerable people to choose MAiD if their organs were in high demand, since many who qualify for MAiD still have healthy organs and tissues. Downar recommended that organ donation not be brought up unless the patient has already definitively chosen MAiD. People contemplating MAiD often feel like a burden, and any suggestion from their health care provider that choosing MAiD might benefit others places undue pressure on them.

“Medically assisted death” comes down to people at their most vulnerable trying to hold on to a sense of control. Organ donation gives one more illusion of control: the illusion that this apparent altruism will give your life and death a meaning it otherwise would not have. This illusion further masks the inherent dignity each human being has as an image bearer of God – the God who, in health or sickness, is in control.

Perhaps organ and/or tissue donation will impact, or already has impacted, your life in an important way. But in the context of euthanasia, organ donation is an expansion of an evil that our society has not only legalized, but also promoted through funding. Using organs from MAiD patients is in line with Planned Parenthood selling the body parts of aborted babies – the abortion is happening anyway, but profiting further off those dead babies is ethically wrong, whether or not the mother approves it in advance. Perhaps, instead of being encouraged, MAiD recipients should be disqualified from donating their organs, sending a message that their life, not their death, defines their meaning.

The ethical implications of MAiD go far beyond the individuals choosing it. The impact it has on families, friends, and now potentially also strangers, means it is an issue we need to keep talking about. We need to ask ourselves hard questions. We need to be ready to give a defense for our position, and willing to hold the line against evil even when there is potential benefit to us or our loved ones.

And then we can move beyond the negative to the positive, to a life infused with love for God and our neighbours. How we care for our elderly, disabled, chronically and mentally ill, how we treat pre-natal and post-natal diagnoses; all of these are opportunities to let the light of Christ shine through us as we self-sacrificially care for others as fellow eternal souls.

With Psalm 91 we pray: “Before the mountains were brought forth, or ever you had formed the earth and the world, from everlasting to everlasting you are God. You return man to dust and say, “Return, O children of man!” For a thousand years in your sight are but as yesterday when it is past, or as a watch in the night. …So teach us to number our days that we may get a heart of wisdom. Return, O Lord! How long? Have pity on your servants! Satisfy us in the morning with your steadfast love, that we may rejoice and be glad all our days.”