Medical Assistance in Dying

On June 17, 2016, the federal government passed Bill C-14, which outlines requirements that patients must meet to be eligible to receive medical assistance in dying (MAID), and establishes safeguards that a doctor or nurse practitioner must follow to legally provide medical assistance in dying.

What is Medical Assistance in Dying?

The term Medical Assistance in Dying, describes: 

  • the administering by a physician or nurse practitioner of a substance to a person, at their request, that causes their death; or
  • the prescribing or providing by a physician or nurse practitioner of a substance to a person at their request, so that they may self-administer the substance and in doing so cause their own death.

The drugs and services required for MAID are available at no cost to the patient.

Patient Eligibility 

The eligibility requirements for MAID are that the patient must: 

  • be 18 years or older, 
  • be capable of making health care decisions, 
  • have a grievous and irremediable medical condition, which means:
    • the patient has a serious and incurable illness, disease or disability, and
    • the patient is in an advanced state of irreversible decline in capabilities, and
    • the patient is enduring physical or psychological suffering, caused by the medical condition or the state of decline, that is intolerable to the person, and
    • the patient's natural death has become reasonably foreseeable;
  • be making a voluntary request; 
  • provide informed consent to MAID after having been informed of the means that are available to relieve their suffering, including palliative care

Additional guidance related to the provision of MAID for health care providers, including physicians, nurses and pharmacists, is being provided by their respective regulatory colleges. 

MAID in the North West LHIN

The North West LHIN is planning to facilitate and support a standardized approach to implementation of MAID across the region. The LHIN actively participates at various provincial and local tables. Within the North West LHIN, Thunder Bay Regional Health Sciences Centre (TBRHSC) has taken the lead role of facilitating and engaging regional service providers, particularly, the hospitals by creating a regional group. The group meets quarterly with the purpose to share, disseminate, and discuss pertinent information related to MAID, and provide guidance and support for implementation of MAID at the individual organizational level. The working group has representatives from pharmacies, physician practices, the Regional Palliative Care Program, LHIN, CCAC and all hospitals in the North West LHIN. 

Health Service Providers

Health service providers are responsible for providing access to MAID to their patients by identifying processes to address any requests for MAID.

Provincial Resources

The Ministry of Health and Long-Term Care (MOHLTC) has developed a webpage that provides the general public, patients and providers with MAID-specific information, guidance and resources. The ministry continues to host webinars with system partners to engage, inform and support implementation of MAID. Several resources for clinicians are also available through their respective colleges including educational webinars. 

The ministry has also established a toll-free referral support line to help Ontario clinicians (physicians and nurse practitioners) to arrange for assessment referrals and consultations for patients requesting MAID. Clinicians are encouraged to use their existing professional networks and work within their institutional policies to support effective referrals prior to accessing the service. Currently, there are clinicians from the North West LHIN that are members of the support line. 

Next Steps

Planning and dialogue with all service providers will continue through the regional working group, so that a coordinated approach is established for accessing MAID in the North West LHIN.

For more information, please visit the Ministry of Health Long-Term Care’s MAID landing page at http://www.health.gov.on.ca/en/pro/programs/maid/