Life, Dignity, and Choice: Understanding Medical Assistance in Dying

Over the past couple of years, Medical Assistance in Dying (MAID) has been making waves in the Healthcare industry. This is a big deal because it touches on personal choice, ethics and what is means to have control at the end of one’s life.

As Canadian laws change and opinions continue to shift, it’s important to understand what MAID all it is about, how it may affect you or someone you love, and the importance of having an Estate Plan.

What is Medical Assistance in Dying?

MAID refers to the medically supervised (and/or assisted) process where eligible individuals can end their own lives to relieve pain and suffering caused by incurable illness, disease, or disability.

In Canada, this conversation reached a pivotal moment with the Carter v. Canada case. In 2015, the Supreme Court of Canada ruled unanimously in this case that parts of the country’s Criminal Code prohibiting medical professionals from assisting in a patient’s death were unconstitutional.

The Court found that the prohibition violated Section 7 of the Charter of Rights and Freedoms, which protects the right to life, liberty, and security of the person.

Following this groundbreaking decision, the Canadian government had a year to draft new legislation in response, leading to the formal legalization of Medical Assistance in Dying (MAID) in 2016.

The Carter v. Canada case arose from the personal stories of individuals like Kay Carter and Gloria Taylor, both of whom suffered from debilitating conditions, making it a poignant testament to the importance of personal autonomy at the end of life.

Who Qualifies for MAID in Canada?

The qualifications for MAID are ones that are not taken lightly. According to the Ontario Government Website, there are various criteria that MUST be met for an individual to qualify which are:

• Eligible for publicly funded health care in Canada
• Minimum of 18 years old
• Capable of making health care decisions/be of sound mind
• Voluntarily request MAID and not have been persuaded or pressured
• Have a grievous and irremediable medical condition: a serious and incurable illness, disease or disability; are in an advanced state of irreversible decline in capability; and are enduring physical or psychological suffering, caused by the medical condition or state of decline that is intolerable and cannot be relieved.

Changes to Legislation

On March 9, 2023, legislation received Royal Assent to include Canadians whose only medical condition is mental illness, and who otherwise meet all the required criteria. These mental illnesses are limited to conditions that are primarily psychiatric, such as severe depression and personality disorders. This amendment to the legislation will be available to eligible Canadian as of March 17, 2024.

After a doctor or nurse practitioner has confirmed that you have met all the above criteria, you are then sent to a second medical professional to complete another medical assessment.

What is the Timeframe to Receive MAID

After your request for medical assistance in dying has been approved, you must wait at least 90 days from the date of your first assessment before you can receive assistance. This allows you to have adequate time to think about and process your decision.

In certain cases where natural death or loss of capacity to provide informed consent may come earlier than 90 days, medical professionals may approve a shorter wait time.

Your content goes here. Edit or remove this text inline or in the module Content settings. You can also style every aspect of this content in the module Design settings and even apply custom CSS to this text in the module Advanced settings.

What is the Process of Receiving MAID?

1. Verbal or Written Request
2. Arranging Time/Location to Receive Assistance
3. Ability to Withdraw
4. Waiving Final Consent

Verbal or Written Request

Once you have decided that you are ready to receive medical assistance in dying, you must first make a verbal or written request, in most cases, to your doctor or nurse practitioner.

After your medical professional determines that you meet all the eligible requirements, a second medical professional must provide a written opinion which confirms that you meet all the requirements.

To receive MAID, a written request must be signed and dated by your medical professional.

Arranging Time/Location to Receive Assistance

When you are ready to receive medical assistance in dying, and after you have given your written or verbal request and it has been approved, you may arrange for a time and place to receive your medical assistance.

In Ontario, you have the choice of receiving assistance in any one of the following:

• At the hospital
• In the comfort of your own home
• In a long-term care home/assisted living residence
• In a hospice or palliative care home
• Any other place you feel comfortable

Ability to Withdraw

You can withdraw your request for MAID at any time. There is no law or contract that will force you to go through with medical assistance with dying if you no longer wish to do so.

Before MAID is administered, the medical professional with confirm with you that you are:

1. Certain you do not want to withdraw from your request for MAID;
2. Confirm that you are still of sound mind and are mentally capable of making the decision;
3. Willing to give your final consent to proceed

Waiving Final Consent

Before medical assistance in dying can be provided, your medical practitioner will be required to have you sign off on your final consent. They will once again ask if you would like to withdraw your request and if you are consenting on your own behalf.

However, if you have already been approved for MAID, but are no longer able to give consent, your medical practitioner may be able to provide medical assistance in dying if:

• Your natural death has become foreseeable
• Your procedure for medical assistance in dying has been scheduled
• You do not refuse or resist having the substance administered

Final thoughts on Medical Assistance in Dying

Medical assistance in dying brings a myriad of emotions, thoughts, and ethical debates. At its core, it’s about autonomy, compassion, and the deeply personal choice of how one wishes to end their life when faced with unbearable suffering.

While it’s crucial to have strict guidelines and safeguards, it’s equally essential to remember the human aspect of this decision.

Every story is unique, and as society grapples with the implications and ethics surrounding this topic, it’s imperative to approach it with empathy, understanding, and respect for individual choices.