Medical Assistance in Dying (MAiD) is the process whereby a doctor or nurse practitioner helps and supports a patient who wants to voluntarily and intentionally end their life. Medical Assistance in Dying is administered with drugs that can be taken by mouth or given intravenously. Watch: Medical Assistance in Dying in Canada (05:12s)
When thinking about the end of your life and saying goodbye to those you love, you may feel a deep sense of grief and sadness. You may also feel relieved to have some control over when and how you will die, and knowing a plan is in place. Our guide to supporting patients and families going through Medical Assistance in Dying (MAiD) aims to answer any questions you or your loved ones may have, provide practical information, and ease your concerns.
Contact Island Health’s MAiD program
We are here to help you navigate the Medical Assistance in Dying process. Please contact us with any questions you may have.
250-727-4382 (Greater Victoria)
Toll Free: 1-877-370-8699
maid@islandhealth.ca
Update (March 17, 2021)
On March 17, 2021, the federal government passed new legislation (C-7) relating to medical assistance in dying. The legislation introduced a number of changes to the Criminal Code, which are now in force. These changes include new eligibility criteria for providing MAiD to those who have a “grievous and irremediable condition.” There are now two pathways of eligibility: a person’s natural death is reasonably foreseeable (RFND), or their natural death is not reasonably foreseeable. This page reflects the changes introduced by the new legislation.
For in-depth detail, please see Medical Assistance in Dying - Province of British Columbia.
Eligibility for MAiD
New changes to the legislation have allowed a broader group of people to be eligible to request and receive MAiD. These changes came into effect on March 17, 2021.
To be eligible for medical assistance in dying, you must meet all of the following criteria:
- be eligible for health services funded by the federal government, or a province or territory (or during the applicable minimum period of residence or waiting period for eligibility)
- be at least 18 years old and mentally competent (capable of making health care decisions for yourself).
- have a grievous and irremediable medical condition
- make a voluntary request for MAID that is not the result of outside pressure or influence
- give informed consent to receive MAID
You do not need to have a fatal or terminal condition to be eligible for MAiD.
Canadians whose only medical condition is a mental illness, and who otherwise meet all eligibility criteria, will not be eligible for MAiD until March 2027 (About mental illness and MAiD).
MAiD Forms
The required forms for Medical Assistance in Dying are located on the BC Ministry of Health MAiD website.
MAiD Public Handout
Information for Island Health patients and families in the MAiD public handout.
The MAiD Process in BC
Talk to your doctor or nurse practitioner about the end-of-life care options available to you. If you are considering MAiD, they can help you navigate the process or refer you to someone who can help. This process also ensures you are aware of all the care options available to you and that you have the information required to make an informed decision. These care options may include comfort care, pain control, hospice care, palliative care, or other options. You do not have to accept any of these services, but it is important you know about them before you pursue MAiD.
Should you choose to go ahead with Medical Assistance in Dying, you can always change your mind and stop the process any time. If you pursue MAiD, palliative care support is still available to you.
The Process:
- Complete the Request form
-
You can request a copy of this form from your doctor or nurse practitioner, or access it directly by visiting the BC Government, Medical Assistance in Dying webpage.
By signing this form, you are formally asking for MAiD and stating that you believe you meet all the eligibility criteria.
(This booklet will help answer any questions: HLTH 1632-Request for MAiD- Instructions).
- Submit completed request for MAiD that includes:
-
- your signature and date.
- the signature and date of one independent witness, who must also sign and date the request (date must be the same as yours).
The role of the independent witness is to confirm the signing and dating of the request by the person requesting MAiD, and that they understand what they are signing. An independent witness must:
- be at least 18 years of age and understand what it means to request MAiD.
- can be a paid professional personal or health care worker.
- the witness cannot:
- benefit from your death
- be an owner or operator of a health care facility where you live or are receiving care
- be an unpaid caregiver.
- Undergo assessments
-
Two assessments are required. These assessments ensure that you are aware of other options, that you meet the criteria for Medical Assistance in Dying and that you have the mental capacity to make this important decision. Two different doctors or nurse practitioners each do a separate assessment. If they are not sure whether you are capable of making the decision, a medical professional with expertise in mental capacity may be consulted.
- There are now two patient pathways (RFND, not RFND):
-
- “Reasonably foreseeable natural death” (RFND)
- a waiver of final consent is now possible (if should lose capacity while waiting for a chosen date). You would discuss this with your MAiD provider, and a form would need to be completed. (Waiver of Final Consent).
- Not “reasonably foreseeable natural death”
- there is a minimum 90 days for an “assessment period.”
- there is no waiver of final consent option.
- Decide where you want Medical Assistance in Dying to take place
-
Once told you are eligible, you can decide where you want Medical Assistance in Dying to take place. This can be in your own home, in a long term care setting, in hospital or another location. You can also decide if you’d like anyone with you when MAiD is administered.
If you are receiving care from an Island Health program, they can help you arrange support or other services to make you as comfortable as possible.
Requesting MAiD While in Hospital
If you are in hospital, a physician can assess you for MAiD and arrange for a medically assisted death. Inpatients of the Royal Jubilee or Victoria General Hospitals can access MAiD through an in-house referral, assessment and provision service. Contact the MAiD Program at maid@islandhealth.ca or 250-727-4382, or ask the Clinical Nurse Leader (CNL) on your ward for more information.
Medical Assistance in Dying Providers
Within every health care jurisdiction, including within Island Health, there are physicians (doctors) and nurse practitioners who are willing and able to provide, or help to provide, Medical Assistance in Dying. They can perform one of the two medical assessments and complete the required forms, as well as provide information and support on how to proceed with MAiD.
What if my Doctor or Nurse Practitioner Won’t Provide MAiD?
For a variety of reasons, not all doctors and nurse practitioners will provide Medical Assistance in Dying and no one is required by law to do so. You can expect your request for MAiD to be received in a compassionate and respectful manner, and that you will be referred to an alternative provider if necessary. If you need assistance, contact the Island Health MAiD Program: maid@islandhealth.ca
Bereavement Resources for Medical Assistance in Dying
Choosing MAiD is a deeply personal decision. When someone close to you has requested MAiD, it is common to experience a wide range of feelings and reactions. Even if you are supporting the choice, it is normal to have conflicting thoughts and emotions.
Our MAiD Support and Bereavement Guide is available to help you to navigate these feelings in the lead up to your loved one’s assisted death and after your loss.
The national organization Bridge C-14 offers Peer-to-Peer Drop-in Grief Support Sessions and many resources for all age groups.
There is also a local Bereavement Support Group for the loved ones left behind to address some of the emotional and existential needs.
Experiences of grief-bereavement after a medically assisted death in Canada: Bringing death to life
MAiD Legislation
Medical Assistance in Dying has been legal in Canada since June 2016 (Bill C-14). This federal law sets out the eligibility requirements and processes under which MAiD can be provided to a patient.
The law was revised on March 17, 2021. Bill C-7 amends the Criminal Code to now permit MAiD for individuals whose natural death is not reasonably foreseeable.
MAiD Family Support Society
Free, one-to-one peer support for people supporting someone choosing MAiD or grieving a MAiD loss. To request support and connect with a volunteer please email: info@maidfamilysupport.ca.
The MAiD Family Support Society is a group of individuals providing peer support who have personal experience of going through MAiD with a loved one. They have come together to volunteer support for others and make the path leading up to MAiD and the grief following a little easier for others.