MAiD

On Tuesday, the Grief and Loss group sponsored a talk by Linda Cliff on Medical Assistance in Dying. It is a difficult topic, but one that affects us all whatever our personal beliefs.
In the six months since the law was enacted, B.C. has reported the highest number of medically assisted deaths in Canada, 188.  Of those deaths the highest per capita rate is on Vancouver Island, 77 deaths. 
It is natural to think that a person's death, natural or medically assisted, affects only that person, but there are ramifications for health care professionals as well as for society at large. 

•  Doctors and nurses must decide it they are willing to administer lethal doses of drugs.  Healthcare professionals are not required to participate in medical assisted dying procedures, but they must provide the information if asked.   It is still illegal to counsel a person to commit suicide.
• The coroner records MAiD deaths.  They are not considered natural deaths.
• Pharmacists must consider the legal and moral implications of filling prescriptions so that patients can commit suidice.  
• Insurance companies are re-examining their policies with regard to payouts for suicide deaths.  
• The Pension Act, and similar laws had to be adjusted for the new reality of medically assisted death.
• For patients and their families, MAiD is now part of the conversation when death approaches.

While Bill C-14 concerns the use of medicine and medical professionals to assist a person to die, the bill is actually about the law rather than medicine.  It speaks of "exemption from criminal prosecution" for health care providers, and lays out very strict guidelines as to when MAiD is legal.  The criteria are:

• patients must be eligible for provincial health services. i.e. non-Canadians cannot come here and ask for MAiD
• patients must be 18 years of age and capable of making decisions about their health. i.e. mentally competent
• have a grievous and irremediable medical condition
• have made a voluntary request for MAiD
• give informed consent to receive MAiD after receiving all information needed to make a decision, including:
• medical diagnosis
• available forms of treatment
• available options to relieve suffering, including palliative care
• have a serious illness, disease or disability
• an advanced state of decline that cannot be reversed
• suffering unbearably from illness, disease, disability or state of decline
• be at a point where natural death has become reasonably foreseeable.

The bill includes safeguards.  The patient must meet all conditions and make the request in writing, give informed consent and make the request of their own free will.  There is a 10 day waiting period between the day the request is signed and the day chosen to carry out the request.  The patient can withdraw consent at any time, including immediately before MAiD is delivered.

Other safeguards:

• There must be two independent witnesses present.  
• Witnesses may not be a beneficiary of the will of the patient.
• owners or operators of a health care facility, or any person directly providing personal care to the person making the request, may not be witnesses.
• the order for MAiD must be signed by two authorized health professionals.
• MAiD is not available to children or mature minors
• MAiD cannot be requested in an advance directive.

To read bill C-14 for yourself click here.

Alberta Health Services has created a values assessment tool that some might find interesting.  It is available here.
The website www.westcoastad.ca may be useful for further exploration of this subject.
For a summary of the Presbyterian Church in Canada's position on euthanasia click here

To see an on-line discussion of MAiD in the Presbyterian Church go here.