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Talking Palliative Care Part 5: Understand Medical Assistance in Dying

Receiving a life-limiting or terminal diagnosis brings with it a lot of difficult decisions that a person never wants to be in the position to make. The hardest of those is choosing to end treatment. Coming to terms with that reality and how it can affect a person’s family is not easy. Some people may consider the option of medical assistance in death. Today we are discussing this relatively new law and how it works in Canada.

What is MAID?

Legislation was passed in 2016 to make medically assisted deaths legal in Canada. This bill outlined the definition, process and eligibility for patients to medically end their life. Medically assisted deaths are considered a medical procedure where medications are administered to the patient. Patients who qualify for MAID have one of two options for administration of the medications. Eligible patients can either choose to have the medication given by a physician or nurse practitioner or it can be prescribed by one. If a person chooses to have the medication prescribed, then they would self-administer the drugs orally.

Who is eligible for MAID?

In order to receive MAID a patient must be1:

  1. 18 years of age or older
  2. be capable of making health care decisions,
  3. have a grievous and irremediable medical condition, which means:
    1. the patient has a serious and incurable illness, disease or disability, and
    2. the patient is in an advanced state of irreversible decline in capabilities, and
    3. the patient is enduring physical or psychological suffering, caused by the medical condition or the state of decline, that is intolerable to the person, and
    4. the patient's natural death has become reasonably foreseeable;
  4. be making a voluntary request;
  5. provide informed consent to medical assistance in dying after having been informed of the means that are available to relieve their suffering, including palliative care.

Beyond these criteria, a person would need to submit a written request to a physician signed by two independent witnesses. Once the physician approves the request, a second physician must review and approve the request and the patient’s eligibility. Once the request has been submitted, the patient must wait 10 days before any medication can be administered2. A person can choose to change their mind at any point in the process. Finally, a patient must confirm consent immediately before the medications are administered3.

MAID in real life

Last year, one metastatic breast cancer patient made headlines when she brought attention to MAID and the realities of the law. In Canada, a person who is choosing MAID cannot make an advanced request. As we mentioned above, a patient must confirm their consent right before taking the medications. This means that a person will still need to be mentally capable of communicating their wishes right up to their death. Audrey highlighted how this specific requirement in the law meant that she was unable to live for as long as she would have liked.

Who can I speak to about whether it is right for me?

Medically assisted death is not for everyone. Whatever your reasons, choosing medical assistance in dying or allowing it to happen naturally is a personal choice that you have the right to make. Here are some resources to help you better understand the Medical Assistance in Dying laws in Canada:

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