Medical Assistance in Dying (MAiD)
Individuals and their families have many decisions to make when faced with end-of-life care or intolerable suffering. It’s important for British Columbians to know and understand all the health care options available to them.
Medical Assistance in Dying (MAiD) refers to a doctor or nurse practitioner helping an eligible person, at the patient's capable, voluntary, and explicit request, to end their life. MAiD became legal in the Criminal Code of Canada in June 2016 and underwent legislative review and changes again in early 2021, setting out the current eligibility requirements, safeguards, and assessment processes under which medical assistance in dying can be provided to an eligible patient.
Deciding to have medical assistance in dying is deeply personal. Anyone thinking about this is encouraged to talk with their family, their loved ones, and anyone else who can support them through the process, including the doctor or nurse practitioner caring for them.
While you consider MAID, It Is recommended that you speak with your doctor or nurse practitioner to discuss your suffering and medical condition. Care teams should ensure you know how to address your suffering. You do not have to accept any of the services that might be offered.
You can change your mind at any time about when to proceed or if to proceed at all.
Step 1. Request for MAID
If you do wish to make a request for MAID and be assessed for eligibility the first step is to complete and submit a Request for Medical Assistance in Dying form to the Assisted Dying Program. Your doctor, nurse practitioner, or other care team members can help you with this. By signing this form, you are:
- Formally asking to be assessed for MAID
- Saying you feel you meet the eligibility criteria
- Consenting to a minimum of two independent assessments to determine if you are eligible
Step 2. Assessments
Your medical team or the Assisted Dying Program will arrange two assessments. The assessment process makes sure you:
- Are aware of all the options to treat your suffering
- Meet the eligible criteria
- Are capable of making this decision
Two different medical professionals (doctors and/or nurse practitioners) must each do their own assessment. Each
assessment will include an in-person or telemedicine visit with you. The assessors might also discuss your case with your current care team. If they are not sure whether you are capable of making the decision, or if they require a consult from an expert in your condition, a medical professional with extra expertise in these areas may also be involved.
Step 3. Waiting Period
If you are being assessed and found eligible for the track that includes those without a reasonably foreseeable natural death, Federal Law requires your assessment period be a minimum of 90 days. Those with a reasonably foreseeable natural death to do not have to undergo a set assessment period.
You can choose to set a date for your assisted death whenever you wish. It is common to not make plans right away, and you can contact the Assisted Dying Program when you are ready. You can talk more about this with the assessors.
While planning for the assisted death procedure
- It may be a benefit to include your loved ones in the planning
- You will need to make plans with a funeral home before receiving MAiD
- It is encouraged that you contact your life insurance company before receiving MAiD
Remember that you may pause or withdraw your request at any time.
Step 4. Assisted Death
Once eligible, you can decide when and where your assisted death will take place. You can choose to have your assisted death in your own home, or in a facility setting that allows for assisted deaths. If you prefer another location, it can be explored. You may also choose to have family or friends with you when you receive your assisted death.
For more information on the process, see the FAQs section below.
Frequently Asked Questions
What is the difference between Physician Assisted Death, Euthanasia, or Medical Assistance in Dying, etc?
Many terms are used regarding Medical Assistance in Dying, and sometimes those terms are used interchangeably. However, Medical Assistance in Dying speaks to all the different terms in that it includes both physicians and nurse practitioners assisting death, as well as the different types of assistance (for example, providing the medication for someone to self-administer versus administering the medication to the person).
What if I think I’m eligible for MAiD?
If you feel the list of criteria applies to you and want more information, you can talk to your doctor or nurse practitioner or call or email the Assisted Dying Program at Vancouver Coastal Health directly.
Please understand individual doctors and nurse practitioners are not obligated to participate directly in the process if they do not personally agree with it, but it is their professional responsibility to connect you with other care providers who can help you explore your request.
Is MAiD available in rural and remote areas?
Yes, it is available in all regions of Vancouver Coastal Health.
What is Bill C-7?
Bill C-7 proposes to amend the Criminal Code of Canada regarding Medical Assistance in Dying. Specific amendments will change the eligibility criteria, safeguards, and waiver of final consent. During this time and for a short period afterwards, the Assisted Dying Program will be working on updating the information available to you. Learn more about the Bill C-7 Act on the Department of Justice Canada.
What if I have difficulty communicating or signing forms?
This does not exclude you from being eligible, but it may mean extra coordination and planning between you, your health-care team, and/or the Assisted Dying Program. If you are physically unable to sign the form, a proxy will need to be arranged. If you have difficulty communicating, or need the assistance of a translator, coordination will take place to ensure effective and reliable means of communicating, for example including translation services or a speech-language pathologist.
Can I request MAiD in an advance directive, or can someone request on my behalf?
No. At this time requests and assessments for an assisted death cannot be provided based on an advance directive, other advance care plan, at the request of a substitute decision-maker, or power of attorney. Only the patient themselves can request and consent to Medical Assistance in Dying.
Can I choose the medical team involved in my planned death?
Yes, as long as the health-care professionals are qualified and authorized to be involved, and there are sufficient personnel to ensure you receive Medical Assistance in Dying safely. Keep in mind that health-care professionals are not obligated to provide or participate in assisted deaths, however they do have the professional responsibility to ensure patients have access. As well, the health-care provider who prescribes or administers the medications and will be present for your death, will be a member of the Assisted Dying Program, and work along side your existing health-care team.
Will a planned death impact my pension or life insurance policy?
Our program has not heard of a Canadian insurance policy payout being negatively impacted by a patient/resident/client receiving an assisted death. However, contacting your life insurance company/pension provider is important to clarify if they may be impacted.
What is a provision?
Provision refers to the procedure of Medical Assistance in Dying. You may hear health-care providers referring to your 'provision day' which means the day of your planned death. We are moving away from the term, and are instead using planned death.
Can friends and family be present at the time of my planned death?
Yes. The number of friends and family present can be at the patients request and agreed upon by the care team, depending on specific resources, specific circumstances, policies, and other factors.
Where can a planned death take place?
Planned deaths can be provided in most health care facilities, at the patient's home, at a designated Medical Assistance in Dying location, or at other locations agreed upon by the patient and care team.
What are the medications that will be administered to cause death?
The medications used include agents to numb the vein and treat pain, put the person to sleep, relax their muscles, and stop the heart and lungs. All of these medications are used on a daily basis within health care. These medications, including their risks and effects, will be explained to you during the eligibility review process.
Once administered, how long does it take for death to occur?
With intravenous administration most patients lose consciousness quickly, and die within minutes. The oral route can take much longer and varies from person to person based on absorption and tolerance.
Can I donate my organs and/or eyes?
Yes, it may be possible to receive an assisted death and donate your organs or eyes. This is reviewed and determined on a case by case basis after being found eligible for MAiD. For more information visit the contacts below and share your wish to donate with your MAiD Provider.
Toll free: 1-800-663-6189
Eye Bank of BC
Toll free: 1-800-667-2060
What if my loved ones don’t agree with my decision? How can I help them understand?
Often the person considering medical assistance in dying is further ahead in their decision-making process than their family members may be expecting. It is important to have open and honest discussions. These discussions may be emotional too. Recognizing the importance of family relationships as well as the bereavement process, resources are available to assist you and your loved ones uncertainty or disagreements. These include social workers, counsellors, spiritual care providers and clinical ethics teams. Your physician and local care team can help connect you to these and other bereavement resources. Coming soon to the Resources section will be a booklet specifically focused to the support of loved ones.
Forms for MAiD in BC
MAiD - BC Government
MAiD - Canada.ca
Organ donation after MAiD - Transplant BC
Eye Bank of BC
End-of-life planning - Canada.ca
Guide For Medical Assistance in Dying booklet
VCH MAiD brochures
Journey record sheet
Grief and bereavement resources
Talking to children about MAiD
Third annual report on MAiD in Canada 2021
Second annual report on MAiD in Canada 2020
First annual report on MAiD in Canada 2019
Criteria for MAiD
You may be eligible for an assisted death if you feel you meet all the criteria below if you:
- are at least 18 years of age;
- are eligible for publicly-funded health services in Canada;
- can make your own decisions about your health, and this decision in particular;
- have a grievous and irremediable medical condition that is:
- you have been diagnosed with a serious and incurable illness, disease, or disability;
- you suffer unbearably from your medical condition, either physically or psychologically;
- your medical condition has advanced or declined to the point where it cannot be reversed
- have been informed of the means that are available to relieve your suffering, including palliative care;
- are making this request of your own free will and not because of pressure or influence from others.
Your medical condition does not need to be fatal or terminal to meet the eligibility criteria. It does, however, need to be serious and incurable. For example, osteoarthritis is serious and incurable but is not fatal or terminal.
Being found ineligible for MAiD
If an Assessor informs you that they have found you not eligible for Medical Assistance in Dying, there are a few things you can do.
You can also request another assessment from a different provider. There is no restriction on the number of assessments a patient can have. If you wish to seek additional Assessors outside our health authority, the Assisted Dying Program can connect you with Care Coordination Services across BC.
You may decide to accept and explore other care options. You are encouraged to work with your health-care team to create a care plan that addresses your needs in an alternative way. You are encouraged to create an Advanced Care Plan in which your wishes and plans for end-of-life care are written. For more information, refer to the links in the Key Terms.
You may request to be reassessed at another time if your clinical condition changes.
Whatever you decide, your health-care team is here to work with you through this process and to honour and respect your wishes. If you, your health provider, or your family have more questions about medical assistance in dying, please get in touch with the Assisted Dying Program directly:
- Phone: 1-844-550-5556 (toll-free within BC) or 1 (604) 875-4249 (outside of BC)
- Email: email@example.com
- Fax: 1 (888) 865-2941
Tell us about your experience with MAiD so we can improve our services. Please follow the links below:
End-of-life care options and MAiD
Other end-of-life care options may include comfort care, pain control, terminal sedation, hospice care, palliative care, and more.
You may receive palliative care and MAiD at the same time. They are separate services, and it is common for MAiD patients to also to be receiving palliative care at the same time.