Medical assistance in dying (MAiD) is the latest development on the path of increasing patient autonomy. Since last summer, when the federal government enacted legislation allowing for the provision of MAiD in certain circumstances in Canada, more and more Canadians have been seeking this service.
In Canada, the debate on physician assisted suicide has been ongoing since 1972, when suicide became decriminalized, while assisting and abetting suicide were still considered criminal acts.
In February 2015, the Supreme Court of Canada decided that it will no longer be a criminal offence in Canada for physicians to help someone end their life in certain circumstances. The court gave provinces and territories until June 6, 2016, before its decision took effect. Thus, MAiD became legal in Canada since June 17, 2016.
Medical assistance in dying occurs when a physician or a nurse practitioner provides or administers medication that intentionally brings about the patient’s death, at the request of the patient.
For example, a physician directly administers a lethal dose of medication in accordance with the wishes of the patient.
In accordance with the Supreme Court ruling, this procedure will only be available in limited circumstances.
To be eligible for MAiD the person should be suffering from an irremediable medical condition that causes them considerable physical or psychological suffering, their death should be reasonably foreseeable, and they should have the ability to provide informed consent. Additionally, the person should be at least 18 years of age, and should make a voluntary request, free from coercion, despite being offered palliative care options to relieve their suffering.
Alberta Health Services has developed a MAiD Care Co-ordination Service to act as a single point of contact for patients, families and health-care providers. Two teams have been set up; one based in Edmonton and another based in Calgary to support the northern and southern half of the province, respectively.
Albertans can initiate a discussion about MAiD with their family physician or specialist. Physicians qualified and trained in MAiD, can provide patients with all the information required to make informed choices about treatment, including diagnosis, prognosis and treatment options, and about MAiD.
If a physician does not wish to participate in MAiD, patients can contact Alberta Health Services care co-ordination centre through 811. They can access information, resources, and also have their questions answered through Alberta Health Services central care co-ordination service (MAID.careteam@ahs.ca).
The patient may stop or pause at any step, including on the day of administration of MAiD.
Up until March 27, 103 patients have been provided MAiD in Alberta. According to Alberta Health Services, the average age of the Albertans who chose to end their lives is 67, with the most cited health conditions being multiple sclerosis, cancer or amyotrophic lateral sclerosis (ALS). Another 48 patients were denied the service because they did not meet federal criteria.
Procedures were carried out in homes as well as hospitals and long-term and continuing care facilities.
In September 2016, AHS reported that it has been struggling to keep up with the increasing demand for MAiD, since only a few physicians/nurse practitioners feel comfortable helping someone end their life.
Driving the demand for mAiD might be partly driven by the non-availability of appropriate palliative care for people suffering from painful, debilitating, terminal conditions. If each one of us had access to excellent palliative care that would relieve pain, and discomfort associated with incurable diseases, the number of people clamoring for the right to die would drop significantly.
Perhaps as a society, we should be investing our resources on research on therapies to address suffering, so everyone can continue to live with dignity until life naturally ends.
Padmaja Genesh can be reached at padmajaganeshy@yahoo.ca