Withdrawal of Life Sustaining Measures

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:

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). https://doi.org/10.1007/s12630-020-01774-6

Downar J, Delaney JW, Hawryluck L, Kenny L. Guidelines for the withdrawal of life-sustaining measures. Intensive Care Med. 2016;42(6):1003-1017. doi:10.1007/s00134-016-4330-7


  • Withdrawal of Life-Sustaining Measures Canadian Critical Care Society Guideline Implementation and Quality Assurance Workshop: Meeting Report (June 2017) English
  • 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) French

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