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Medical Assistance in Dying

Tuesday, October 25, 2016

Nancy M. Merrow, M.D., Chief of Staff & Vice President of Medical Affairs

As of June 6, 2016 assisted death became legal in Canada.  Across North Simcoe Muskoka, there has been an organized effort to pull together the services needed so we can respond effectively to people who request Medical Assistance in Dying (MAID).

When someone asks for help to die, there is an opportunity to make sure they are cared for with all of the compassion and skills our community can provide. It is very important to understand deeply what is happening for that person, and to create a care plan that relieves their suffering. When working with a person who is asking to die, health care professionals and others have a duty to talk about all the options that might make the person’s illness easier to bear. Symptoms like pain or depression can make life much harder than it needs to be, and a lot of help is available.

As people become more comfortable talking about dying and more familiar with what hospice palliative care can do, requests for MAID will be only one part of a bigger conversation and care plan. Knowing that everything that can be done is being done to make the person more comfortable and to ease the distress for loved ones is important for everyone who is left behind to remember the death, however it comes.

At OSMH, a policy and procedure and advisory group is in place to help our doctors, nurses, clergy, social workers and pharmacists plan for MAID if requests occur when a person is in the hospital. However, it is much more likely that MAID will occur in the person’s own home. The hospital will work closely with all community care providers to help patients get what they need. Although some doctors or nurse practitioners may choose not to provide the service, in Ontario, it is their professional duty to refer the person to a doctor or nurse practitioner who is able to offer the service.

Once a request for medical assistance in dying is made, a doctor or nurse practitioner must assess whether the person is eligible. . There are a number of conditions required by law, to do with the person’s age (over 18), illness, state of mind and nearness to death.

The doctor or nurse practitioner will make sure the request is voluntarily. They will also discuss options available to relieve suffering, including palliative care, before getting the person’s informed consent.. The person will be encouraged to settle all their final affairs like wills and burial wishes. A second doctor or nurse practitioner must complete another assessment to confirm eligibility. At least 10 days must pass before assistance in dying is provided, starting from when the written request is signed by the person, to give the person time to think about the decision. In some cases, the doctors or nurse practitioners may approve a shorter waiting period. The person can cancel the request at any time.

Your family doctor or nurse practitioner are your main resources. Talk to them about your concerns.

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