Introduction: While more countries are legalizing Medical Assistance in Dying (MAiD), only Canada, Belgium and The Netherlands allow for controlled organ donation following MAiD. Recently, the MAiD legislation in Canada was amended with Bill C-7, which changed the eligibility criteria for MAiD, including safeguards, potential to waive the requirement for final consent at time of MAiD procedure for reasonable natural foreseeable death, and expanding reporting requirements of MAiD procedures. To support updates in the practice guidelines and to ensure safety and ethically acceptable procedures for organ donation following MAiD, we investigated the current literature worldwide on the existing processes, procedures and outcomes regarding organ donation following MAiD.

Method: Scoping review using JBI methodology. Published and unpublished literature of any design were considered if they discussed organ donation following MAiD at home or in any healthcare setting in any country. Databases included Ovid MEDLINE, Ovid Embase, CINAHL via EBSCOhost, Ovid PsycINFO, Web of Science – Science Citation Index and Social Science Citation Index via Clarivate, and Academic Search Complete via EBSCOhost. Gray and unpublished literature included materials from organ donation organizations in Canada, Belgium and The Netherlands. Articles were screened and data extracted and analyzed using a content analysis approach by two independent reviewers. Evidence was collated using a descriptive numerical summary and a narrative content analysis approach.

Results: 1879 reports were identified and 121 were included. The reports were in English (n=95), Dutch (n=17) and French (n=9); majority from Canada (n=51), The Netherlands (n=38), and Belgium (n=14), published between 2019-2021 (n=57). Our content analysis identified several major theme areas: main processes and procedures involved in organ donation after MAiD in the hospital and at home; main clinical pathways involved in different settings; ethical dilemmas involved in this combined procedure; healthcare professionals’ roles and perceptions; impacts on organ donation and transplantation system; transplant outcomes; public perceptions; process and tools in place; educational strategies for healthcare professionals involved; and suggestions for future research to address knowledge gaps.

Conclusion: The results of this review provide important directions for improvements in the current Canadian organ donation system. These findings can also be used as a rich source of information for countries establishing organ donation following MAiD.