Euthanasia & Organ Donation: A New Pool of Donors

The issue of organ donation after euthanasia or assisted suicide was quickly dismissed during parliamentary debates on the proposed law “on the right to aid in dying.” This is regrettable, as such a possibility raises important ethical issues.

In both the National Assembly and the Senate, parliamentarians proposed amending the bill to prohibit organ donation in cases of euthanasia and assisted suicide.[1] Radical at first glance, these amendments mainly expressed their authors' feeling that this practice cannot be taken for granted, particularly because of the danger of a possible slide towards “altruistic euthanasia.” In the case of patients who are not at the end of their lives, an "altruistic euthanasia" would be justified by organ donation itself. These amendments should have given rise to extensive debate, but unfortunately these opportunities were quickly swept aside in both chambers. On May 23, 2025, in a public session, it took just six minutes for MPs to reject the amendment, following an unfavorable opinion from the main rapporteur, who argued that such a measure would violate the principle of equality. On January 20, 2026, the Senate Social Affairs Committee also failed to address the issue when it examined amendment 65 rectified, which was rejected before being dropped. It is therefore important to compensate for the lack of substantive debate on this issue in order to avoid an ethical blind spot.

Aid in dying: a tool to remedy organ shortages?

However, the experience of countries that have legalized assisted suicide and euthanasia teaches us that safeguards are necessary. In Quebec, the 2022 report published by Transplant Quebec[2] notes with satisfaction that the number of organ donors in the context of aid in dying has tripled in five years. The organization notes "a record number of referrals for organ donation in 2022, including a significant increase of more than 130% in the context of medical aid in dying (MAID). Nearly 15% of organ donors had previously resorted to MAID". Thus, while approximately 5% of deaths recorded in Quebec in the same year were the result of euthanasia or assisted suicide, this figure reveals a number of donors three times higher in this category than in that of ”natural" deaths. Given this disproportion, euthanasia and assisted suicide are therefore very useful tools in a context of increasing demand for organs. Specialists make no secret of this, as does the director of Transplant Québec, who states that “This is not only an opportunity to increase the number of organ donors in Quebec, but also an incredible opportunity to allow more people to benefit from a transplant.”[3] In Spain, which legalized “aid in dying” in 2021, authorities were surprised to find that more than 25% of those who used it (44 out of 172) during the first year of the law's implementation donated their organs.[4] The first organ removals were even performed before an official protocol had been published.

In France, this “opportunity” for euthanasia and assisted suicide as a new source of organs is also an argument that has been well understood by the Association for the Right to Die with Dignity. This association has joined forces with Renaloo, an association that supports patients with kidney disease and promotes kidney donation, as evidenced by its participation in the symposium “Overcoming opposition to organ donation: an ethical emergency” organized by Renaloo in October 2024.[5] Furthermore, Henri Caillavet, who carried the law of December 22, 1976, establishing presumed consent for organ donation, is none other than one of the founding members and former president of the French Association for the Right to Die with Dignity.

The expression of a utilitarian view of the human person

There are various reasons for these facts and figures. From a philosophical point of view, euthanasia and assisted suicide radically change the relationship between human beings and life and death: these practices are a response to the absurdity of life and suffering in a civilization that is losing its bearings, meaning, and transcendence. Death is dehumanized, while life and the human body are treated as materials to be managed and controlled. However, the prospect of donating one's organs is an extension of the response to this absurdity in that it values altruism. In short, it is a way of combining the useful with a “pleasant death.”[6]

From a technical point of view, once the day and time of death have been planned, the procedure for organ removal and transplantation is necessarily facilitated, as some members of parliament have pointed out in public session. But once the patient has decided and obtained permission to undergo euthanasia or assisted suicide on the one hand, and to donate their organs on the other, priority will then be given not to aid in dying, but to organ removal: euthanasia or assisted suicide will be performed in such a way as to ensure the success of the transplant. This is illustrated by the case of a 16-year-old Belgian girl suffering from a brain tumor who asked to be euthanized and to donate her organs:[7] scheduled for July 2023, her “euthanasia [...] began on Thursday evening and ended 36 hours later, on Saturday morning,” in order to complete the removal and transplantation.

Even though the stated objective is to allow a person to die with dignity, such facts necessarily raise questions about compatibility with respect for human dignity. Dignity requires that every human being be considered an end in itself and not a means to an end.

“You can save lives by dying” or the risk of pressure

It is still permissible to question the risk of pressure that people, especially the most vulnerable, might be under to end their lives to give their organs. This could be the case, for example, with cross-donation, for which the 2021 bioethics law authorized the use of an organ removed from a deceased person. In Quebec, while doctors have been authorized since 2018 to discuss the subject with a patient who could donate their organs as part of aid in dying, ethical rules[8] stipulate that this can only be done after the aid in dying admission procedure has been completed. In France, on the other hand, it is a criminal offense to interfere, as if pressure could only be exerted in one direction: to dissuade a person from ending their life. Even without being under real pressure, it is not inconceivable that the request for aid in dying could be influenced by the prospect of being able to do good by donating one's organs, particularly when the person is weakened by illness, especially mental illness, which may be compounded by loneliness or poverty. It would be a way of giving meaning to one's death when one believes that one's life no longer has any meaning, a way of dying usefully instead of living uselessly or feeling like a burden to others. The risk of such “moral obligations” to die raises questions about compatibility with respect for personal autonomy, even though this is another objective stated by supporters of the legalization of euthanasia and assisted suicide.

Finally, the rapid dismissal of the issue of organ donation in the context of euthanasia and assisted suicide amounts to imposing the view that this practice is a matter that should not be questioned. However, countries that have legalized it continue to question its ethics. From this point of view, too, the current bill lives up to its reputation as the most permissive and repressive in the world when it comes to end-of-life issues. It is therefore important that parliamentarians take a serious look at the issue of organ donation in the context of euthanasia and assisted suicide. This does not mean being against organ donation: on the contrary, it means raising the debate on these related practices to a level of quality that is commensurate with the ethical issues and risks of abuse when it comes to life and death.

By Grégor Puppinck and Priscille Kulczyk.

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[1] Amendments 246, 635, and 2571 in the National Assembly and 65rectifié in the Senate.

[2]Transplant Québec, 2022 Report on Organ Donation in Quebec - Organ Donation in the Context of Aid in Dying: Three Times More Donors in Five Years, Press Release, February 8, 2023.

[3] Ibid.

[4] One year of euthanasia in Spain: 172 cases and great inequality between autonomous communities, El País, June 22, 2022.

[5] See the ADMD press release, November 6, 2024.

[6] Etymologically, the word euthanasia comes from the Greek “eu” and “thanatos,” meaning “good death.”

[7] Eva, 16 years old: euthanasia and 5 organs removed, Gènéthique, October 17, 2023.

[8] Transplant-Québec Ethics Committee. Opinion. June 2018.