Medical Assistance in Dying

Information for Patients, Clients and Residents

Deciding whether medical assistance in dying is right for you is a very personal choice. Everyone is different, and has different wishes. Regardless, it is normal to ask questions about medical assistance in dying if you are considering it. It is important to understand that not every person who inquires about medical assistance in dying will be eligible. Whatever you decide, your health care team is here to give you the care you need, while respecting your wishes. The decision is always yours to determine if you would like to proceed with medical assistance in dying, or explore other options.

What is medical assistance in dying? 

In Canada, medical assistance in dying refers to procedures in which a physician or nurse practitioner assists a patient, client, or resident (“patient”) who wishes to voluntarily and intentionally end their life, either by administering a lethal dose of a medication or providing the patient a prescription so they may end their life through self-medication. 

Is medical assistance in dying legal? 

On June 17, 2016, medical assistance in dying became law (Bill-C-14) in Canada and Prince Edward Island.

What are the criteria to receive medical assistance in dying? 

In order for you to receive medical assistance in dying you must: 

  • be at least 18 years old and capable of making decisions about your health;
  • be eligible for health services funded by a government of Canada;
  • have a grievous and irremediable medical condition (including an illness, disease or disability); 
  • have made a voluntary request that was not influenced by external pressure; and 
  • give informed consent after having been informed of the means that are available to relieve your suffering, including palliative care.

What is the process if I wish to receive medical assistance in dying? 

You can request medical assistance in dying by speaking to your family physician or nurse practitioner who is most responsible for your care. If you do not have a family physician or nurse practitioner, or would prefer to speak with someone else, we encourage you to call 8-1-1 and a registered nurse will refer you to another health care provider who can help you.

Your physician or nurse practitioner will discuss any concerns about your health care situation with you and, together with you and other colleagues, ensure you have considered all of the services or treatment that are available. These may include comfort care, pain control, hospice care, palliative care or other options. You are not obligated to accept any of these services, but we want to make sure you are aware of all available alternative services and supports, including palliative care, before you pursue medical assistance in dying. 

If you wish to proceed and your physician or nurse practitioner is not willing to participate in medical assistance in dying, for moral or other reasons, they will tell you and will refer you to a physician or nurse practitioner who can help you. 

Patient Requests
The “willing” physician or nurse practitioner will provide a form to document your request, review with you whether you meet the criteria and will ask another physician or nurse practitioner to confirm the criteria have been met. Professional regulations (and the law) require that two physicians or nurse practitioners are required to independently determine if you meet the criteria for receiving medical assistance in dying.

Assessment 
The Assessment process ensures that you are aware of other options; that you meet the criteria for medical assistance in dying; and, that you are capable of making this important decision. Two different physicians or nurse practitioners must each do separate assessments. Either or both physicians/nurse practitioners may ask for a psychiatric assessment to help them clarify their understanding if there is a concern that you might not be capable to make this very important decision.

The Reflection Period
If the assessments by both physicians/nurse practitioners show that the criteria has been met, there is a 10 day period of reflection before medical assistance in dying can take place. This period begins once you have signed the request form for medical assistance in dying. The waiting period can be shortened in certain circumstances, as decided by your physician(s) and/or nurse practitioner(s). 

Who will provide medical assistance in dying?

One of the physicians/nurse practitioners already involved in your care may be the “Provider” – meaning that individual will order and administer the medications to end your life – or another physician or nurse practitioner may be involved. The “Provider” will also need to confirm for himself/herself that you meet the criteria. 

Can I choose where I receive medical assistance in dying? 

Yes, you can choose where you want to receive medical assistance in dying. The physician/nurse practitioner will work with you to consider where the medical assistance in dying procedure will take place, and support you in securing support or other services that may help to make you as comfortable as possible until medical assistance in dying takes place.

What if I change my mind about receiving medical assistance in dying? 

The physician or nurse practitioner involved in your request for medical assistance in dying will ask you at various points throughout the process if you still wish to proceed with the service. You have the right, at any point in time, to change your mind about receiving medical assistance in dying. It is important that you share any concerns or doubts you may have with the physician or nurse practitioner as they arise so they can discuss them with you. 

Is there a fee to receive medical assistance in dying? 

No, there is no fee to request or receive medical assistance in dying. 

Can someone else request medical assistance in dying on my behalf?

To seek medical assistance in dying, you are required to be competent at the time of the act of medical assistance in dying. Substitute decision-makers (such as court-appointed guardians, or health care proxies under a Health Care Directive) cannot make the decision to request medical assistance in dying on your behalf if you are no longer competent to make your own treatment decisions.

What about my privacy, does my family need to know about my medical assistance in dying decision?

Health PEI is governed by the Freedom of Information and Protection of Privacy Act [PDF | 284 KB], and personal information will only be collected, used and disclosed in accordance with that Act. Accordingly, your consent is required before we disclose your personal information to your family unless one of the particular legislative exceptions applies.

 

Published date: 
January 25, 2017
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