Medical assistance in dying (MAID) became legal in Canada in June 2016, after the federal government passed Bill C-14. In Nova Scotia, MAID is governed by the Professional Standard Regarding Medical Assistance in Dying, a document developed by the College of Physicians & Surgeons of Nova Scotia.

Medical assistance in dying is an emotionally charged topic, but it’s easier to understand when you have the information you need. Here are answers to some commonly asked questions about MAID.

WHAT IS MEDICAL ASSISTANCE IN DYING?

Medical assistance in dying is when a person suffering from a grievous, irremediable medical condition is given a lethal dose of drugs by a physician or nurse practitioner at the patient’s request.

WHAT IS A GRIEVOUS AND IRREMEDIABLE CONDITION?

A patient is considered to have a grievous and irremediable medical condition if they are:

• suffering unbearably from a serious (but not necessarily terminal) illness, disease or disability
• in an advanced state of decline that cannot be reversed
• at a point where natural death has become reasonably foreseeable

People with a mental illness are eligible for MAID if they meet the eligibility criteria (below). However, patients are not eligible for MAID if:

• they are suffering only from a mental illness
• death is not reasonably foreseeable
• a mental illness reduces their ability to make medical decisions

WHO IS ELIGIBLE?

In order to be eligible for MAID, a patient must:

• be at least 18 years of age and mentally competent
• be eligible for government-funded health services (federal or provincial/territorial)
• have a grievous and irremediable medical condition
• make a voluntary request for MAID
• give their informed consent

HOW DOES A PERSON APPLY FOR MAID?

Applying for MAID requires careful thought, multiple medical consultations, a written application and a mandatory 10-day waiting period. The first step is to consult a physician or nurse practitioner. The patient’s health-care provider may recommend exploring palliative care or hospice care first.

CAN THE PATIENT CHANGE THEIR MIND?

Patients can change their mind at any time in the process. Patients are not obligated to proceed with MAID even if deemed eligible for the service. Patients will be given a final opportunity to withdraw their request just before receiving MAID.

CAN OTHERS MAKE THE DECISION ON THE PATIENT’S BEHALF?

Only the patient can request MAID. If the patient is physically or mentally incapable of making the decision, others can’t make the decision for them. This means that physicians or nurse practitioners can’t act on a request for MAID set out in a personal directive or similar document. All requests for MAID must be made directly by the patient, and safeguards are in place.

DO ALL PHYSICIANS AND NURSE PRACTIONERS OFFER THIS SERVICE?

Physicians and nurse practitioners may choose not to offer MAID, but they must follow professional requirements set by the College of Physicians & Surgeons of Nova Scotia. These requirements state that health-care providers who do not provide MAID must refer patients to a physician or nurse practitioner who does.

WHAT ARE THE OPTIONS?

As much as possible, the service will be provided where and when the patient wants, accompanied by whomever the patient wants (some people may choose to be surrounded by willing family or friends, for example). Patients may choose to have a physician or nurse practitioner directly administer a substance that causes death or they may choose to have their health-care practitioner prescribe a substance that the patient can self-administer at the time of their choice.

WHERE CAN I LEARN MORE?

To learn more about MAID, palliative care and hospice care, talk to your family physician.

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