In 2016, the Canadian Critical Care Society published a withdrawal of life sustaining measures (WLSM) guideline with the intent of standardizing WLSM practices and quality assurance frameworks.

A crucial aspect of the DCD process, Canadian Blood Services convened a pan-Canadian and multidisciplinary collaborative to examine the WLSM guideline and create implementation and quality tools to support the adoption of the guideline in hospitals across the country. 

A set of guiding principles for implementation of the guideline in DCD practice were produced, as well as implementation and quality assurance tools. 

Journal Publications

Is the process of withdrawal of life-sustaining measures in the intensive care unit different for deceased organ donors compared with other dying patients? A secondary analysis of prospectively collected data - PubMed (

Francoeur C, Hornby L, Silva A, Scales NB, Weiss M, Dhanani S. Paediatric death after withdrawal of life-sustaining therapies: a scoping review protocol.  BMJ Open. 2022 Sep 19;12(9):e064918. doi: 10.1136/bmjopen-2022-064918.PMID: 36123110 

Healey, A., Hartwick, M., Downar, J. et al. Improving quality of withdrawal of life-sustaining measures in organ donation: a framework and implementation toolkit. Can J Anesth/J Can Anesth (2020). 

Downar J, Delaney JW, Hawryluck L, Kenny L. Guidelines for the withdrawal of life-sustaining measures. Intensive Care Med. 2016;42(6):1003-1017. 


PDF copies of the following reports are available by request. Submit a request by sending an email to, please include the title and use the subject line: PDF Document Request.

  • Withdrawal of Life-Sustaining Measures Canadian Critical Care Society Guideline Implementation and Quality Assurance Workshop: Meeting Report (June 2017)
  • Arrêt des traitements de maintien des fonctions vitales Atelier sur la mise en œuvre et l’assurance qualité des lignes directrices de la Société canadienne de soins intensifs (June 2017)

For additional resources, visit the Withdrawal of Life Sustaining Measures Resources page.

Resources include:

Implementation Tools

  • WLSM Checklist 
  • WLSM Documentation Tool 
  • WLSM Information for Families 
  • WLSM Order Set 

Quality Assurance Tools

  • WLSM Policy Template 
  • WLSM Case Audit Tool 
  • WLSM System Audit Tool 

Withdrawal of Life Sustaining Measures - Clinical Tools and Resources

End-of-life conversations with families of potential donors - Leading practices in offering the opportunity for donation

Canadian Clinical Guide to Organ Donation