EXCLUSIVE — Deputy Health and Human Services Secretary Jim O’Neill condemned Canada’s permissive physician-assisted suicide program for ill patients, which he said has crossed ethical boundaries by increasing deceased organ donation rates.
O’Neill, the second-in-command at HHS and acting head of the Centers for Disease Control and Prevention, told the Washington Examiner in an exclusive interview that he was disturbed to learn that Canada’s physician-assisted suicide program, operating under the label Medical Aid in Dying, has enabled it to become a world leader in organ transplant policy from deceased donors.
Demand from the millions of patients worldwide who need an organ transplant greatly outpaces supply, leaving organ donation policy ripe for perverse incentives. In the United States, an average of 13 people die every day waiting for an organ transplant.
O’Neill and Health Resources and Services Administration chief Thomas Engels have said that they are trying to revive trust in the American Organ Procurement and Transplantation Network after multiple troubling reports of organs nearly being harvested from live patients in several states, including Kentucky and New Jersey.
But O’Neill said that Canada’s program was uniquely problematic compared to even the most egregious stories in the U.S.
“We thought we’d seen all the possible horrors, you know, in America, and then Canada had this strange new horror that was really just shocking,” said O’Neill.
The Canadian Medical Association Journal published a paper in 2024 outlining a “substantial increase in deceased donation” in Quebec during the first five years of the MAID program.
From 2018 to 2022, the number of deceased donors who died by physician-assisted suicide increased from 4.9% in 2018 to 14% in 2022.
A broader study of Canada, Belgium, the Netherlands, and Spain, published in the American Journal of Transplantation in 2022, found that 286 people across the four countries donated their organs after physician-assisted suicide. Nearly half of those donors, 136, came from Canada.
But the number of organ donors is still relatively small compared to the nearly 16,500 Canadians who died by physician-assisted suicide in 2024.
The Canadian Health Service reported in November that roughly 60% of MAID recipients in 2024 had cancer, which in most Canadian provinces would preclude them from choosing to donate their organs upon death.
The Canadian Institute for Health Information reported in 2024 that 62 Canadians donated their organs after physician-assisted suicide, accounting for only 7% of the less than 900 total deceased donors across Canada.
O’Neill said that he has not spoken with his Canadian counterpart about the matter, but the apparent link between assisted suicide and organ donation rates in Canada “is very unfortunate.”
In the U.S., 14 states have legalized physician-assisted suicide, most recently Illinois, as of December. The growing adoption of physician-assisted suicide across the country has led some opponents of the practice to speculate that the U.S. will evolve in the same direction as Canada.
State laws on physician-assisted suicide are much stricter than those in Canada, where the national parliament next month will review whether patients suffering from mental illnesses can choose MAID. In Illinois and elsewhere in the U.S., two physicians or healthcare providers must certify that the patient has less than six months to live before choosing physician-assisted suicide.
DELAWARE PHYSICIAN-ASSISTED SUICIDE LAW UPHELD BY FEDERAL JUDGE
O’Neill, who says he has opposed physician-assisted suicide for his entire career, told the Washington Examiner that HHS will continue to pay attention to “everything that touches or affects the supply of organs or the integrity or pressure that could be put on patients and families,” including pressure to remove life support.
“There’s so many factors and so many potential conflicts of interest that we are always looking for ways to improve every single part of organ donation, whether it’s living donors or deceased donors,” O’Neill said.
