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Medical Assistance in Dying

Physicians and nurse practitioners across Canada can now provide medical assistance in dying.

Federal legislative changes to the Criminal Code, passed on June 17, 2016, guides how Canada’s physicians and nurse practitioners are allowed to provide this medical procedure as a health care option. This legislation follows a Supreme Court of Canada ruling Carter v. Canada, where medical assistance in dying was recognized as a constitutional right when certain criteria are met and became legal on June 6, 2016.

End-of-life care and medical assistance in dying are important, sensitive, and emotional issues. Patients have many decisions to make when faced with end-of-life care or intolerable suffering. Yukon residents are encouraged to know and understand all the health care options available to them.

You can ask to receive medical assistance in dying no matter where you live or receive care. This includes:

  • a hospital
  • a long-term care home
  • your home

If you’re already in a hospital or long-term care home, speak to your physician, nurse practitioner or care provider about your options. 

Frequently asked questions about medical assistance in dying (MAID)

What is medical assistance in dying?

Medical assistance in dying occurs when a physician or a nurse practitioner provides or prescribes medication that will intentionally bring about the patient's death, at the request of the patient. For example, a physician or nurse practitioner can directly administer a dose of medication that causes death or provide medication that a patient may self-administer. In accordance with the Criminal Code, this procedure will only be available in limited circumstances where certain eligibility criteria are met.

Is medical assistance in dying legal?

Yes. Medical assistance in dying is now legal in Canada. 

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 February 6, 2016, before its decision took effect, and then extended this date to June 6, 2016. Amendments to the Criminal Code have been made to give effect to this court decision.

What is the role of the Yukon government compared to the federal government?

Medical assistance in dying laws and guidelines are in place both federally and territorially. The federal government is responsible for the Criminal Code on medical assistance in dying.

The provinces and territories create health care laws about things like health insurance, the regulation of health professions, medical consent/decision-making, and hospitals. Yukon is therefore responsible for all of these matters as they apply to medical assistance in dying.

Yukoners are covered for this service by the Yukon Health Care Insurance Plan (YHCIP) and drugs required for medical assistance in dying will be available at no cost.

What criteria must be met in order for an individual to access medical assistance in dying:

According to the Criminal Code, for an individual to access this service, he/she must:

  • be eligible for health services funded by a government in Canada;
  • be at least 18 years of age and capable of making decisions with respect to their health;
  • have a grievous and irremediable medical condition, as defined in the Criminal Code;
  • make a voluntary request for medical assistance in dying that, in particular, is not made as a result of external pressure; and
  • give informed consent to receive medical assistance in dying, after having been informed of the means that are available to relieve suffering, including palliative care.

Two medical practitioners and/or nurse practitioners must agree that the person making the request is eligible for medical assistance in dying.

What is a Grievous and Irremediable Medical Condition?

A grievous and irremediable medical condition is where a patient meets the following criteria:

  • they have a serious and incurable illness, disease or disability;
  • they are in an advanced state of irreversible decline in capability;
  • that illness, disease or disability or state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable; and
  • their natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining.

What are the safeguards around medical assistance in dying?

Safeguards have been created to protect patients and health care providers. Many of safeguards include:

  • assessments by two independent medical practitioners or nurse practitioners to ensure the patient meets the eligibility criteria;
  • ensuring the patient expressly consents to medical assistance in dying and has a signed and witnessed request made;
  • ensuring that the patient knows they may withdraw their request at any time;
  • taking all measures to reliably communicate with a patient should they have difficulty in communicating;
  • requiring a mandatory reflection period before medical assistance in dying is provided;
  • immediately before providing the patient with medical assistance in dying the patient has the opportunity to withdraw their request and provides express consent for medical assistance in dying.

How does someone access medical assistance in dying?

Yukoners interested in medical assistance in dying must speak with their family physician, specialist or a nurse practitioner.

Physicians or nurse practitioners can provide patients with all the information required to make informed choices about treatment, including diagnosis, prognosis and treatment options, palliative care, and about medical assistance in dying.

Medical practitioners, nurse practitioners and other health care providers may provide patients with information about the lawful delivery of medical assistance in dying. It remains an offence under the Criminal Code for anyone to counsel suicide which means that medical practitioners and nurse practitioners cannot encourage, counsel, recommend or in any way try to influence a person to seek to end their life.

Medical practitioners, nurse practitioners and others in a caregiving relationship with a patient, or those in a relationship of authority or responsibility over a patient – should take care to avoid inadvertently encouraging someone to choose medical assistance in dying.

Medical assistance in dying may be the right option for some, but there are many other options that need to be part of the conversation, including palliative care.

If a physician or nurse practitioner does not wish to participate in medical assistance in dying, it is the nurse practitioner or physician’s responsibility to refer to the patient to someone who is willing to assist.

Health care providers, including physicians, nurse practitioners and pharmacists, should refer to their regulatory colleges for more information and guidance.

What if I change my mind after requesting medical assistance in dying?

Patients requesting medical assistance in dying can change their mind and rescind their request at any time.

It’s very important that patients have time to reflect on their decision so, following a patient’s request for medical assistance in dying, a mandatory reflection period of at least 10 days must occur between the day the written request is signed and the day medical assistance in dying is provided, unless death or the patient's loss of capacity are imminent.

Immediately before the doctor or nurse practitioner provides medical assistance in dying – whether in the form of administering, providing or writing a prescription – they must confirm with the patient that they are still sure that this is what they want and the patient must provide consent to proceed.

How do I learn more about palliative care in Yukon?

Palliative care is a type of health care for patients and families facing life-threatening illness. Palliative care helps patients to achieve the best possible quality of life right up until the end of life. Palliative care is also called end-of-life, or comfort care. 

Palliative care honours a person’s choice and responds not only to their physical care, but also to their spiritual, cultural and psychosocial needs, as well as those of their family. Palliative care throughout Yukon is not limited to one location but can be provided in a variety of care settings, including Whitehorse General Hospital, Continuing Care facilities, and a person’s home.

Palliative care services in Yukon include:

  •  physical, psychosocial and spiritual assessments as appropriate;
  • pain and symptom management, including symptoms which are hard to control or to deal with;
  • complex care situations;
  • discharge planning support; in particular, to the communities;
  • public and professional training and education; and
  • supporting issues of loss, grief and bereavement.

Individuals living with a life-limiting illness who wish to improve or maintain their quality of life may refer themselves for Palliative Care services, or have someone else call on their behalf. For more information visit the Palliative Care Page or call 867-456-6807 | Toll-free in the Yukon: 1 (800) 861-0408, extension 6807.

References

Supreme Court Decisions on Medical Assistance in Dying

Reports on Medical Assistance in Dying

Health Care Provider's References

Information references for health care providers on medical assistance in dying.

more information

Documents

Contact info

Medical Assistance in Dying

Phone: 867-667-5695

Toll Free (Yukon, Nunavut and NWT); 1-800-661-0408 ext. 5695

Mailing Address:

Medical Assistance in Dying (H-1)
Health & Social Services, Government of Yukon
Box 2703
Whitehorse, Yukon  Y1A 2C6

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