Country	Main legislation	Criteria for MAiD	General rules for organ donation consent
Belgium	Belgian Euthanasia Act (2002)*	Competent individuals Attained majority age or is an emancipated minor The request is voluntary They are in “a medically futile condition of constant and unbearable physical or mental suffering that cannot be alleviated”(p.1)	Presumed consent (opt out) system: the patient is considered in favor of donating their organs unless they express their desire otherwise.4
Canada	Bill C-14103 (2016) and later modified by Bill C-7† (2021)	Competent individuals 18 years or older The request is voluntary They have a “grievous and irremediable medical condition”(p.1) Give informed consent	Explicit consent regime: the patients directly indicate their choice of organ donation (eg, in the health card; opt-in). The exception is Nova Scotia, as it has a presumed consent system (opt-out). The patient is considered in favor of donating their organs unless they express their desire otherwise.5
The Netherlands	Dutch Euthanasia Act (Dutch Termination of Life on Request and Assisted Suicide Act) 2002105	Competent individuals 12 years or older The request is voluntary They are experiencing “unbearable suffering with no prospect of improvement”(p.1)	Active donor registration system: the patient (if not registered by own choice) is notified and asked about their desire for organ donation. If no response is obtained, the patient is registered as “no objection to organ donation,” which means that consent is assumed.4,26,41

^*–The Belgian Act on Euthanasia of May 28th 2002. Eur J Health Law 2003;10:329–35.

^† –Parliament of Canada. Bill C-7: An Act to amend the Criminal Code (medical assistance in dying), C-7, forty-third parliament, second session (2021) [internet]. Parliament of Canada; 2021 [cited 2021 May 4]. Available from: https://parl.ca/DocumentViewer/en/43-2/bill/C-7/royal-assent.