MAID

Question 1

DEFINITION OF MEDICAL
ASSISTANCE IN DYING

Answer 1

 In accordance with federal legislation, MAID includes
circumstances where a medical practitioner or nurse practitioner, at an individual’s request:

(a) administers a substance that causes an individual’s
death (previously referred to as euthanasia) or

(b) prescribes a substance for an individual to self- administer to cause their own death (previously referred to as physician assisted suicide)

Question 2

CONSCIENTIOUS
OBJECTION

Answer 2

• When an individual healthcare professional, due to matters of personal conscience, elects not to participate in MAID
• The level of comfort and support an individual professional may or may not be willing to provide will likely vary in scope
• For example individual healthcare professionals may be comfortable supporting a range of activities such as:

 Having an exploratory discussion with the patient or providing a second medical opinion but are not willing to prescribe or administer

 Limiting their involvement in MAID to the full extent permitted by their professional regulatory colleges

 Remember: ask about your institutional processes around MAID since they can
vary significantly

Question 3

DUTY TO PATIENTS
IRRESPECTIVE OF
CONSCIENTIOUS OBJECTION

Answer 3

 Although physicians may refuse to treat a patient due to
conscience or religious objection they still must…

• Respect patient dignity
• Ensure access to care
• Protect patient safety
• Not abandon the patient

Question 4

PHYSICIANS MUST PROVIDE AN
EFFECTIVE REFERRAL

Answer 4

An effective referral means a referral made in good faith to a non-objecting, available, and accessible physician, another health-care professional, or agency.

 Physicians must not impede access to medical assistance in dying, even if it conflicts with their conscience or religious beliefs.

Question 5

10 STEP PROCESS

Answer 5

1 Patient makes initial inquiry
 2 Exploring a request for MAID
 3 Patient makes written request
 4 Period of reflection
 5 First clinician assessment
 6 Second clinician assessment
 7 Informing the pharmacy
 8 Provision of MAID
 9 Certification of Death
 10 Wellness and resiliency post MAID

Question 6

INFORMED CONSENT IN THE
CONTEXT OF MAID

Answer 6

To provide informed consent to MAID, the following four requirements must be met:

 individual must be capable

 the decision must be informed (i.e., risks, benefits, side effects, alternatives, and consequences of not having treatment provided)

 made voluntarily (i.e., not obtained through misrepresentation or fraud)

 be treatment specific (i.e., information provided relates to treatment being proposed)

Question 7

WHO IS INVOLVED?

Answer 7

 MAID includes both (
1) MD/NP administered death or (2) self- administered death further to a prescription by a MD/NP

 RNs cannot administer, but play a key supportive role

 The pharmacist who dispenses MAID medications must be told by the MD/NP the purpose of the medications before they are dispensed

 The Criminal Code does not compel anyone to provide or assist in

Question 8

CHALLENGES IN
DETERMINING
ELIGIBILITY

Answer 8

Is the patient being coerced?
Situations awaiting clarification- currently not eligible Primary mental illness Incapable patients/advance consent
Minors

Conscientious objection vs.
Professional judgment

You meet criteria but I think this is wrong

You don’t meet criteria