The Last Gift

Since Canada legalized medical assistance in dying, a small but growing number of people have chosen, in their final days, to also become an organ donor.

1 in 20 transplants performed in Canada in 2025 began with a donor who had chosen medical assistance in dying
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Medical assistance in dying (MAID) has been legal in Canada since 2016. In the years since, organ donation organizations across the country have built formal pathways so that a person choosing MAID can also choose to donate — following essentially the same clinical process as any donation after circulatory death. The Canadian Organ Replacement Register has tracked these donations as a distinct category since 2021. Here is what five years of that data shows.

Registry entry 01 — the trend

A pathway that is gradually widening

The number of Canadians donating after MAID reached a new high in 2025. The number of transplants made possible has varied from year to year because a single donor can give more than one organ.

Line chart, 2021 to 2025. MAID donors: 58, 57, 58, 63, 69. Transplants from those donors: 142, 125, 141, 158, 154.

Donors Transplants made possible

Over five years, 305 Canadians who chose medical assistance in dying went on to donate organs — making possible 720 transplants for people waiting.

Registry entry 02 — the share

Roughly a fifth of circulatory donors

MAID donors are recorded as a form of donation after circulatory death (DCC) — the pathway used when death is declared by the stopping of the heart rather than by neurological criteria. Their share of that group has held remarkably steady even as both numbers grew.

Measured instead against all deceased donors — including those who died of a neurological cause — MAID donors made up roughly 6% to 8% of the total every year since 2021: about one donor in every thirteen to sixteen.

Registry entry 03 — where

Quebec drove the increase; Ontario remained largest

The regional pattern is uneven. Quebec recorded 16 more donors in 2025 than in 2021, accounting for more than the net national increase, while Ontario remained the largest source. British Columbia and the Prairies recorded modest declines.

2021 2025

Donors are counted where organs were procured, not where recipients were treated — transplants from these donors also cross provincial lines. "Prairies" combines Manitoba, Saskatchewan and Alberta; "Atlantic" combines Newfoundland and Labrador, P.E.I., Nova Scotia and New Brunswick. Atlantic and Prairie counts are small; CIHI cautions against reading too much into single-digit year-to-year moves.

Registry entry 04 — the multiplier

One decision, several gifts

A single act of donation rarely produces a single transplant. On average, each MAID donor since 2021 has made more than two transplants possible.

2.4 transplants made possible per MAID donor, on average, since 2021
2021 2.4 2022 2.2 2023 2.4 2024 2.5 2025 2.2