Medical Assistance in Dying (MAiD) for Assessors and Prescribers

In the landmark decision in Carter v Canada, the Supreme Court of Canada unanimously found that the blanket prohibition on Medical Assistance in Dying in Canada was unconstitutional. In response, the federal government amended the Criminal Code in June of 2016 to legalize Medical Assistance in Dying for competent persons who are at least 18 years of age and who meet the eligibility criteria of a grievous and irremediable medical condition that causes enduring, intolerable suffering. This course is designed to provide physicians and nurse practitioners with the information necessary for them to act as both assessors and prescribers for medical assistance in dying in full compliance with their legal, ethical, and professional obligations.

This course is composed of 4 Modules. Module 1 begins by explaining the legal developments which culminated in the passage of Bill C-14 in June of 2016. After completing Module 1, physicians and nurse practitioners will understand what medical assistance in dying is and how Bill C-14 changed the law of Canada. In addition, Module 1 provides an introduction to the eligibility criteria for medical assistance in dying and explains the federally-legislated and provincially-regulated safeguards that exist to protect patients. Module 1 concludes by setting out the rights and obligations of physicians and nurse practitioners whose individual values and beliefs may conflict with the provision of medical assistance in dying care.

Module 2 details the stages of the patient and family journey in relation to medical assistance in dying, and explains the roles and functions of each member of the healthcare team at each stage. After completing Module 2, assessors and providers will know how to access essential information and resources, including Health Authority Care Coordination and the professional regulatory standards applicable to physicians, nurse practitioners, registered nurses and psychiatric nurses, and pharmacists. Module 2 also provides information on the reporting requirements in relation to medical assistance in dying, and links to the standardized provincial forms required for documenting and reporting case information to the BC Ministry of Health. Finally, Module 2 explains some key considerations when completing the Patient Request Record form.

Module 3 focuses on the assessment process for determining eligibility for medical assistance in dying and provides physicians and nurse practitioners with practical guidance on conducting an assessment. After completing Module 3, physicians and nurse practitioners will deepen their awareness of the patient’s journey and gain an in-depth understanding of the necessary steps in assessing eligibility for medical assistance in dying. This module discusses each of the legislated criteria for eligibility and provides guidance on how to assess whether a patient is capable of requesting and receiving medical assistance in dying, how to document the assessment, and when to involve specialist assessors and other health care professionals.

Module 4 focuses on the role of the medical assistance in dying prescriber and guides physicians and nurse practitioners through each stage of the process, including planning, selection of the route of drug administration (for practitioner-administered or self-administered medical assistance in dying), acquisition of the medication, administration, post-administration support for families and members of the healthcare team, and required documentation and reporting. In addition, Module 4 provides a detailed explanation of the medications composing both the oral and intravenous routes of administration and important clinical guidance on administration. Upon completion of Module 4, physicians and nurse practitioners will have a comprehensive understanding of medical assistance in dying and will be able to comply with their legal, ethical, and professional obligations when providing medical assistance in dying care to patients.