Medical assistance in dying is a controversial topic that not all Canadians agree on.
Medical assistance in dying (MAID) was made legal in Canada in June, 2016 with the passing of Bill C-14, which allows Canadians with terminal illnesses where natural death is “reasonably foreseeable” to choose to die with a doctor’s help. In just less than a year since it’s adoption, it is estimated that over 1,000 Canadians have chosen to die with medical assistance. Data collected by CTV News also showed that most patients who opted for an assisted death suffered from conditions such as cancer or neurological diseases, including MS and ALS.
Whether you support this philosophy and option or not, it’s important to know your rights.
Two types of MAID are allowed in Canada:
1. A physician or nurse practitioner can directly administer a substance that causes the death of the person who has requested it, and
2. A physician or nurse practitioner can give or prescribe to a patient a substance that they can self-administer to cause their own death.
Under Bill C-14, two independent health care professionals need to evaluate an individual to determine whether he/she qualifies for MAID. To qualify, an individual must be 18 years or older and meet the following four criteria:
1. Have a serious and incurable illness, disease, or disability;
2. Be in an advanced state of irreversible decline in capability;
3. Endure physical and psychological suffering that is intolerable to them; and
4. Their natural death has become reasonably foreseeable.
Patients must be 18 years or older, and be capable of providing informed consent at the time that MAID is provided.
And in senior care, where we work, the conversation relating to advanced dementia is an interesting one. Many times I have heard people say something like, “If I get to the point where I have dementia and I have no idea who I am or who anyone else is, my personality changes, and I’m non-functioning, I would want to ‘pull the plug’!” It’s a difficult topic to discuss, but important to think about.
Interestingly, under this MAID law, advance requests for dying are not permitted. This means Canadians with diagnoses of competence-eroding conditions like Alzheimer’s (or other dementias) and Huntington’s disease will not be granted this right while they are still of sound mind and competent to decide on planned death, to be carried out at a later date. And without this advance consent, these individuals will most certainly be found ineligible for MAID because they will likely lose mental competence before they reach the required “advanced state of irreversible decline” outlined in the MAID criteria.
Whether that’s right or wrong is a philosophical debate. And what side of the debate you’re on would most certainly be influenced by whether you or someone you love is in the position of considering MAID. I’m curious to know what you think. Email me at Cowichan@NurseNextDoor.com and share your thoughts on this topic.
For more information on medical assistance in dying go to www.dyingwithdignity.ca