On the two year anniversary of the enacting of federal legislation on Medical Assistance in Dying (M.A.I.D), Health Canada published its third interim report(1). This report provides insight into how many medically-assisted deaths have taken place, the settings in which they occurred, the individual’s age and gender, as well as the most common underlying medical conditions of those who have received an assisted death. The report states that a total 3,714 Canadians have undergone a medically-assisted death since both Quebec and federal legislation came into force. This means that M.A.I.D only accounted for just over 1% of the total deaths in Canada during this reporting period, which is consistent with that of other countries that permit medically-assisted deaths.
The report indicates that in 2017, the majority of individuals undergoing an assisted-death were over the age of 56 (average age – 73 years old) and with a reasonably even distribution between males and females. By far the most common underlying medical conditions were cancer-related; followed by neurodegenerative disorders and circulatory/respiratory system disorder. During 2017, almost all medically-assisted deaths were administered by a physician; with only a small number being administered by a nurse practitioner and almost none being self-administered. Interestingly, there appears to be nearly the exact same number of medically-assisted deaths taking place in a hospital setting as there are in the patient’s home, and relatively few occurring in long-term care homes or hospices.
Loss of competency and death not being “reasonably foreseeable” appear to be the most frequent reasons why requests for M.A.I.D have been declined over the past two years. Bill C-14 currently states that only people who are facing foreseeable death can receive aid to die, and this provision has sparked a number of legal challenges that claim that this criteria is counter to individual Charter rights. In addition, near the end of 2018 the Liberal government received three expert panel reports examining the possibility of extending M.A.I.D to “mature minors” (defined as those individuals under the age of 18 who are considered to be capable of directing their own care), as well as to people with psychiatric conditions and those making requests in advance(2).
Medically-assisted death may now be legal in Canada, but the debate on who should be eligible to receive, as well as other criteria, is far from over. As the framework around M.A.I.D continues to expand and evolve, it is important for RTs to remain knowledgeable. Up-to-date information on M.A.I.D is provided by Health Canada at https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html/ . In addition, specific information on the RT role in M.A.I.D can be found on the CRTO website at http://www.crto.on.ca/members/professional-practice/physician-assisted-death-pad.
(1) Health Canada. (2018, June). Third Interim Report on Medical Assistance in Dying in Canada. Retrieved from https://www.canada.ca/content/dam/hc-sc/documents/services/publications/health-system-services/medical-assistance-dying-interim-report-june-2018/medical-assistance-dying-interim-report-june-2018-eng.pdf
(2) CBC. (2019, Jan. 3). The next frontier in the ‘right to die’: advance requests, minors and the mentally ill. Retrieved from https://www.cbc.ca/news/politics/maid-assisted-death-minors-mental-illness-1.4956388