medical assistance in dying (maid)

Hurrying to meet a looming court deadline, the federal government has given Canadians two weeks to weigh in on how far to extend access to medical aid in dying. The Government of Canada has launched an online public consultation aimed at obtaining Canadian's views on amending the federal medical assistance in dying legislation. Canadians and interested stakeholders are invited to share their views online until January 27, 2020.

Who can provide medical assistance in dying and who can help
Those who can provide medical assistance in dying services are:

• physicians
• nurse practitioners (in provinces where this is allowed)

Those who can help provide medical assistance in dying include:

• pharmacists
• family members or other people that you ask to help
• health care providers who help physicians or nurse practitioners

These people can assist in the process without being charged under criminal law. However, physicians, nurse practitioners and other people who are directly involved must follow:

• the rules set out in the Criminal Code
• applicable provincial and territorial health-related laws, rules and policies

Protecting the right of providers to act according to their beliefs and values

Not all health care providers will be comfortable with medical assistance in dying. The federal practice may not be consistent with a provider's beliefs and values. The federal legislation does not force any person to provide or help to provide medical assistance in dying.
Provincial and territorial governments have the responsibility for determining how and where health care services are provided. They may also make policies around where medical assistance in dying can take place as long as they do not conflict with the Criminal Code.

There are 2 types of medical assistance in dying available to Canadians. They each must include a physician or nurse practitioner who:

• directly administers a substance that causes death, such as an injection of a drug
  • this is becoming known as clinician-administered medical assistance in dying
  • it was previously known as voluntary euthanasia

or

• provides or prescribes a drug that the eligible person takes themselves, in order to bring about their own death
  • this is becoming known as self-administered medical assistance in dying
  • it was previously known as medically assisted suicide or assisted suicide

The consultations will also ask Canadians whether assisted death should be expanded to give people in specific situations access to a doctor or nurse practitioner's help to die:

• So-called "mature minors" — people under age 18 considered by doctors to be capable of directing their own care.
• Cases involving "advance requests" — where a patient stipulates they would like their life to end at a later time when they are no longer competent to give consent.
• And people who wish to end their lives solely because of mental illness.

Process for requesting the service
The legislation contains safeguards to make sure those who ask for medical assistance in dying:

• request the service of their own free will
• are able to make health care decisions for themselves
• are eligible (this means they meet all of the listed criteria)
• can and do give informed consent, which includes being informed of all care options available to them to help relieve suffering

These safeguards will guide health care providers to carry out this service appropriately and in a way that protects people from abuse or misuse.

Talk to your physician or nurse practitioner about end-of-life care options in relation to your medical condition or circumstances.

To participate in the online public consultation: www.justice.gc.ca/eng/cons/ad-am/index.html