Resource

Frequently asked questions for Medical Assistance in Dying (MAiD)

For answers to frequently asked questions about MAiD, click the tabs below.

Introduction to MAID

  • What is Medical Assistance in Dying (MAID)?

    MAID occurs when an authorized doctor or nurse practitioner provides or administers medication that intentionally brings about a person’s death, at that person’s request.

  • What is the difference between Physician Assisted Death, Euthanasia, and Medical Assistance in Dying?

    These terms are often used interchangeably and may be used in different jurisdictions around the world to describe assisted death. In Canada, we use the term Medical Assistance in Dying (MAID). The terms “assisted death” or “assisted dying” are also used to describe the same thing.

  • Is there a cost for MAiD?

    No, those eligible for health services funded by the federal government, or a province or territory have access to MAID at no cost. For example, MSP.

  • How long does the MAID process take?

    Vancouver Coastal Health’s Assisted Dying Program works with clients to ensure access in a timely manner based on the client’s goals, values, and medical needs. The Assisted Dying Program will triage all referrals and connect with clients after a complete application is received. The aim is to make the MAID process as client-driven as possible within the resources available at the time.

  • Can I change my mind about MAID?

    You may change your mind about being assessed for or having an assisted death, at any time, for any reason.

  • Is MAiD available everywhere in B.C.?

    Yes. MAiD is available in all regions of British Columbia, including rural and remote communities. If there are no assessors or providers in your local area, arrangements can be made with your health authority’s MAiD Care Coordination Service. To contact the Care Coordination Service at VCH, please call or email the Assisted Dying Program at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • Where can I have an assisted death?

    You can have MAID in most health-care facilities, at your home, or in some long-term-care, assisted living, and hospice sites. Some faith-based health-care facilities can opt to not allow MAID to take place on-site. There are also designated spaces within Vancouver Coastal Health if you cannot, or do not wish to have your assisted death in your facility. The VCH Assisted Dying Program will make every effort to support your wish to have your assisted death at the location you choose.   

  • Does the health care I am receiving change if I request MAID?

    No. Requesting, being found eligible, or having scheduled an assisted death does not change the health care you receive unless you request a change. MAID is an additional care option you may explore while continuing to receive all other care as normal. You may request some care stop or change, but these changes are directed by you in consultation with your care team. For example, if you have scheduled your assisted death you may decide not to participate with physiotherapy while you wait for the day. However, you may also find physiotherapy provides value to you, and continues to impact your quality of life, and therefore you may wish to continue with physiotherapy up until your assisted death.

  • What are other end-of-life options?

    Other end-of-life options may include comfort care, pain control, palliative care, hospice care, terminal sedation, and more. For more information, speak to your health care team or visit the VCH palliative and end-of-life page to learn more.

  • Can I receive palliative care while exploring MAID?

    Yes. These are separate services, and it is common to receive palliative care while exploring MAID. You will continue to have access to any program and/or health service for which you would otherwise be eligible, even if you have requested, or are considering requesting MAID.

  • Where can I learn more about MAiD?

    You and your family can go to vch.ca and search ‘MAiD’ to access the public VCH Medical Assistance in Dying page. Here, you will find information about MAiD, how to request to be assessed for MAiD and the steps involved, as well as frequently asked questions, a review of the eligibility criteria, and links to grief and bereavement resources. You and your family can also contact the Assisted Dying Program Care Coordinators directly at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

     

Requests for MAID

  • What if I think I’m eligible for MAiD and would like to be assessed?

    If you would like to be assessed for MAiD, you could first discuss this with your doctor, nurse practitioner, or health care team. If you do not want to or are unable to do this, you can contact the VCH Assisted Dying Program for assistance at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

    Alternatively, you can download the Request for Medical Assistance in Dying form yourself, and submit it to the VCH Assisted Dying Program by faxing or emailing it to 1 (888) 865-2941 or AssistedDying@vch.ca.

  • Will my discussions about MAiD be confidential?

    Your health records are protected and kept confidential under the Personal Information Protection Act (PIPA), and the Freedom of Information and Protection of Privacy Act (FOIPPA).

    All discussions with your health-care providers are confidential, including discussions about MAiD. However, it is important to remember that health-care providers are required to document all conversations and health-care services provided to you, including those about MAiD. This documentation is often recorded in an Electronic Medical Record (EMR), which may then be available to other health-care providers involved in your care.

    In addition, if your health-care provider is concerned that you are at risk of harming yourself or others, they are obligated to share and act on this information.

    If you have questions or concerns about who does or might have access to your health records, you should discuss this with your health-care provider. Alternatively, you can contact the VCH Assisted Dying Program at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • What is the process for MAiD?

    The general steps for requesting and having an Assisted Death are:

    If you would like a more detailed review of the MAiD process, please contact the VCH Assisted Dying Program at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • Where can I get the Request for Medical Assistance in Dying form?

    If you would like to be assessed for MAID eligibility, you need to fill out the Request for Medical Assistance in Dying form. Links to this form are available on Vancouver Coastal Health’s public site, vch.ca, or BC’s Ministry of Health site. The completed form can be faxed or emailed to the VCH Assisted Dying Program at 1 (888) 865-2941 or assistedying@vch.ca. You can also call the VCH Assisted Dying Program for assistance with this form at:

    Local: (604) 875-4294
    Toll Free: 1 (844) 550-5556
    Email: assistedying@vch.ca

     

  • Does my doctor or nurse practitioner need to agree with, or consent to, me sending a Request for MAiD form to the Assisted Dying Program?

    No, this can be a client-driven, self-referral process. You do not need a referral, approval, or agreement from your doctor or nurse practitioner to complete and submit the Request for Medical Assistance in Dying form. However, if willing, your health-care providers can assist you in completing and sending in the forms. You may also contact the VCH Assisted Dying Program for assistance at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • What if I have difficulty communicating or signing forms?

    This does not exclude you from being eligible. However, it may mean extra coordination and planning is needed to ensure these barriers do not prevent you from accessing these services or understanding the health-care options available to you. This may include having a proxy available to sign the forms, having an interpreter scheduled for the assessments, or any other assistance needed. If you require assistance with the Request for MAiD form, please notify your health-care team. Alternatively, you may contact the VCH Assisted Dying Program at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • Can I request MAiD in an advance, or can someone request on my behalf?

    No. Requests for an assisted death cannot be made based on an Advance Directive, Advance Care Plan, Representation Agreement, or by a substitute decision-maker. Only you can request to be assessed for, and consent to receive MAID.

  • Who will assess me for MAID?

    You will be assessed by two independent assessors. The assessors will be either a medical doctor or nurse practitioner. Your family doctor may be able to complete your first assessment, and you are encouraged to discuss this with them. However, you are not required to discuss MAID with your family doctor and can submit a request to be assessed for MAID without their consent or approval.

  • Can my family practitioner assess me for MAiD?

    Yes. If your family practitioner has the necessary knowledge and experience they may agree to assess you for MAiD eligibility. Keep in mind that your practitioner is not obligated to assess you for MAiD, or provide an assisted death. They are, however, obligated to connect you to a practitioner who will assist you with this if they are not willing or able to. If you have any questions about this, you can contact the VCH Assisted Dying Program at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

MAID eligibility

  • Who is eligible for MAID?

    To be eligible to have an assisted death, a person requesting MAID must meet the following eligibility criteria:

    • The person is eligible for health services funded by a government in Canada;
    • The person is at least 18 years of age and capable of making decisions with respect to their health;
    • The person has made a voluntary request for MAID that was not made as a result of external pressure;
    • The person has given informed consent to receive MAID after having been informed of the means that are available to relieve their suffering, including palliative care;
    • The person has a grievous and irremediable medical condition:
      • They have a serious and incurable illness, disease or disability;
      • They are in an advanced state of irreversible decline in functional capability;
      • That illness, disease or disability or that advanced state of irreversible decline causes them psychological suffering that is intolerable to them and cannot be relieved under conditions that they consider acceptable.
  • Does my illness, disease, or disability have to be fatal or terminal to be eligible for MAID?

    No, as of 2021, your death does not need to be “Reasonably Foreseeable” to be eligible for MAID.

    If you are found eligible for assisted death, the assessors will determine if you have a Reasonably Foreseeable Natural Death or not. This will determine which safeguards need to be met before you can schedule your assisted death, and if you have to complete the minimum 90-day assessment period before doing so.   

    The procedural safeguards for when a person has a reasonably foreseeable natural death, and when natural death is not reasonably foreseeable can be found here. These are commonly referred to as Track 1, and Track 2, respectively.

  • What happens if I lose capacity to consent before receiving MAID?

    You are required to give final consent prior to having the MAID medication administered. If you are not able to give this consent, you cannot have an assisted death. However, if you are at risk of losing the capacity to give this final consent and you have a reasonably foreseeable natural death, you may be able to sign an agreement with your MAID provider waiving this requirement. This is called the Waiver of Final Consent.

    If you have been assessed and found eligible for MAID, you should ask your MAID provider about your risk of losing the capacity to consent. See below for more information on the Waiver of Final Consent, and when it can be used. 

  • What is the Waiver of Final Consent?

    The Waiver of Final Consent is a written arrangement between you and the medical practitioner or nurse practitioner who will provide you with a medically assisted death. The waiver allows the provider to proceed with the medically assisted death without receiving your final consent if you have lost the capacity to provide that consent.

    The Waiver of Final Consent can only be used under specific conditions:

    • You have been assessed and found eligible to receive MAID
    • Your natural death is reasonably foreseeable
    • You have been advised by your MAID provider that you are at risk of losing the ability to give final consent to receive MAID
    • You are still capable of giving consent to receive MAID at the time the Waiver of Final Consent is completed and signed
    • You have lost the capacity to give final consent on or before the date you scheduled your assisted death, as indicated on the Waiver of Final Consent
  • What if I'm found ineligible for MAID?

    If you are found to be ineligible for MAID, the assessors will discuss with you the reasons for this finding. You then have a few options:

    • You may choose to have another assessment by a different assessor. There are no restrictions on the number of assessments you can have.
    • You may decide to accept the assessor's finding that you are not eligible and choose to explore other care options. You should work with your health-care team to create a care plan that addresses your needs in an alternative way.
    • You may request to be reassessed at another time, if you feel your clinical condition has changed, and might now be eligible.

MAID and mental disorders

  • Can I receive MAID if I have a mental disorder?

    Having a mental disorder does not exclude you from being eligible to receive MAID, if your primary suffering is being caused by another grievous and irremediable medical condition (e.g. you also have advanced cancer), and you meet the eligibility criteria. This legislation is scheduled to change on March 17, 2024. 

    The assessors will work to determine all the sources of your suffering, and then determine eligibility for MAID according to the current legislative requirements.

  • Can I apply for and receive MAID if I have a Mental Disorder as my Sole Underlying Medical Condition (MD-SUMC)?

    No, if you have a mental disorder as your sole underlying medical condition, you are not currently eligible to have a medically assisted death.

    Canadian law will allow people suffering from a mental disorder as their sole underlying medical condition to access MAID beginning March 17, 2024, if they meet all the other eligibility criteria.

  • Can I request MAID if I am involuntarily hospitalized, certified under the Mental Health Act, or subject to a Community Treatment Order?

    Yes. Persons who are involuntarily hospitalized, certified under the Mental Health Act, or subject to Community Treatment Orders are not automatically excluded from making MAID requests. There is nothing in the BC Mental Health Act or the Federal MAID legislation that precludes a person who is certified under the Mental Health Act from applying for MAID.  As with all MAID cases, you would be assessed based on the MAID eligibility criteria, which includes a determination of your ability to make an informed and considered health care choice about MAID.

The client and their families

  • Can my family and friends be present at the time of my assisted death?

    Yes. You can decide who will be present at the time of your assisted death. However, there may be some limitations on the space available for your family and loved ones depending on where you will be having your assisted death, such as in a hospital room. You should discuss this with your MAID provider if you feel you will need more space for your family and loved ones. Your MAID provider and the VCH Assisted Dying Program will make every effort to support your wishes for your assisted death.

  • What supports are available for family/loved ones who are grieving?

    There are a number of supports available for grieving family and loved ones. There are links to grief and bereavement supports on the VCH Assisted Dying Page under Resources – VCH Guides. There are also MAiD-specific grief and bereavement resources such as those provided by Dying with Dignity Canada, the MAID Family Support Society, and Bridge C-14. You can also contact the Assisted Dying Program Care Coordinators for links to additional support at:

    Local: (604) 875-4249
    Toll Free: 1 (844) 550-5556
    Email: AssistedDying@vch.ca

  • Do I need to inform my family or friends that I am thinking about or planning on having an assisted death?

    No, you do not need to inform your family members about your request for MAID.  Your health-care team will not disclose that you have requested or received MAID to your family or friends without your express consent to do so, even after you have received MAID. That said, your family and friends might be impacted if they are not aware that you have requested or received MAID. Assessors and providers may explore your choice to not involve your family or friends with you, and explain the potential harms of non-disclosure to you, but they must respect your privacy and confidentiality.

    Your health-care team must document their interactions with you, including information and health-care services provided to you regarding MAID. Also, if you do have an assisted death, your death certificate will note ‘Medical Assistance in Dying’ and your underlying illness, disease, or disability as the causes of death. Your family may have access to your medical health records and/or death certificate after your death and may become aware that you requested and had an assisted death. You should seek legal advice if you are concerned about this possibility.

  • What if my family and loved ones do not support my decision to have an assisted death?

    If you have requested MAID, it would be normal for your loved ones to experience a wide range of feelings and emotions. They might not agree with your decision to have an assisted death, which may be related to feelings about not wanting you to die. In addition, you may have been considering MAID long before informing your loved ones, or might not be fully disclosing the level of your suffering to them, which can make it difficult for your loved ones to understand your decision. We encourage you and your loved ones to have open and honest discussions about this decision. You may need your health care team’s support with this, which may include social work, counsellors, and spiritual care, among others. Organizations like Bridge C-14 also provide meaningful connections and access to resources for people and their loved ones throughout all stages of the assisted dying process.     

  • Can my family and loved ones prevent me from being assessed for, or having an assisted death?

    No. The decision to be assessed for or have an assisted death is a very personal choice and one only you can make. It is required that the assessors ensure that you are making this decision freely, without undue influence (contemporaneous or past) from family members, health care providers, or others. 

Other questions

  • What medication is administered to cause my assisted death?

    Most assisted deaths in Canada use the IV route to administer the medication to cause death. The IV medications are given to:

    • cause you to go into a deep sleep;
    • place you in a medically induced coma, and
    • stop your lungs and heart, causing death.

    Your MAID provider will discuss the medications with you, and explain the process for you.    

  • Once the medication is administered, how long will it take for death to occur?

    There are two ways to receive the MAID medication: injected through an IV or in an oral solution that you drink.

    • The IV medication takes effect very quickly, and you will fall asleep very shortly after the first medication is given. The entire process is usually completed, with death occurring in 10-15 minutes.
    • The oral solution is much less predictable, and the onset varies with each person, often taking up to or exceeding 1 hour for death to occur.

    You should discuss the risks and benefits of each with your MAID assessor or provider.

  • Will a medically assisted death impact my pension or life insurance?

    The Canadian Life & Health Insurance Association has released a position statement regarding MAID. You should also check with your own pension or insurance provider.

    To date, the VCH Assisted Dying Program is not aware of anyone in Canada being denied their pension or life insurance due to having an assisted death. Your death will be listed as ‘natural’ on your death certificate.

  • Can I make an eye or solid organ donation after an assisted death?

    If you wish to make an organ donation, you should ask your MAID provider about this after you have been found eligible for MAID. Not everyone eligible for MAID will be eligible for organ donation. More information on organ donation after MAID can be found on the BC Transplant website.