To receive MAID in Ontario, you must:

• be eligible for publicly funded health care services in Canada
• be 18 years of age or older
• be capable of making health care decisions
• be able to provide informed consent, which means that you have given permission after you have received all the information you need to make your decision
• voluntarily request MAID
• have a grievous and irremediable medical condition, which means you:
  • • have a serious and incurable illness, disease, or disability
    • are in an advanced state of irreversible decline in capability
    • are enduring physical or psychological suffering, caused by the medical condition or the state of decline, that is intolerable and cannot be relieved

• You do not need to have a fatal or terminal condition to be eligible for medical assistance in dying.
• If your only medical condition is a mental illness, you are not eligible for medical assistance in dying until March 17, 2027.
• If you have a mental illness along with other medical conditions, you may be eligible for medical assistance in dying.
• Eligibility is always assessed on an individual basis and takes all relevant circumstances into account. However, you must meet all the criteria to be eligible.

¹ It is important to note that the requirement the patient/client be 18 years of age to consent to MAID is a departure from Ontario’s Health Care Consent Act, which does not specify an age of consent.

² The informed consent for MAID must be obtained by the physician or NP who is authorizing the procedure. RTs cannot obtain consent for MAID.

Even though RTs will not be directing the plan of care in situations in which a patient/client has requested assistance to end their life, an RT may be asked to assist in carrying out a request for MAID. For example, an RT may be asked remove a patient/client from a ventilator or insert an IV*. Fortunately, most of the parameters that will govern the RT’s role in MAID already exist in normal, day-to-day practice. All the current expectations regarding obtaining valid orders, documentation, patient/client confidentially, competence and ethical conduct, etc., still apply for RTs who are part of the care team implementing a request for MAID – just as it does for any other practice scenario.

* RTs are not permitted to administer any medications for the purpose of MAID.

The legislation requires a patient/client’s request for MAID to be signed and dated by two (2) “independent witnesses”. An independent witness in this context is someone who:

• is at least 18 years of age;
• understands the nature of the request for MAID;
• has no financial or material interest in the patient/client requesting MAID (e.g., beneficiary in the patient/client’s will);
• does not own or operate the healthcare facility where the patient/client is being treated; and
• is not directly involved in providing care to the patient/client requesting MAID.

An RT who meets all of the above criteria may act as an independent witness to a request for MAID.

Bill C14 states that:

(s. 5.1) For greater certainty, no social worker, psychologist, psychiatrist, therapist, medical practitioner, nurse practitioner or other health care professional commits an offense if they provide information to a person on the lawful provision of medical assistance in dying.

RRTs are permitted to provide information and engage in discussions with their patients/clients regarding the lawful provision of medical assistance in dying (MAID). Resources, such as this brochure produced by the Ontario Ministry of Health and Long Term Care entitled Medical Assistance In Dying: Information for Patients, as well as other material provided by employers, may be used to aid these discussions. If the patient/client wishes to be assessed in order to determine if they meet the criteria for MAID, the RRT should then refer the individual to the appropriate physician or nurse practitioner.

Please note that RRTs must not discuss any aspect of MAID with the patient’s/client’s family or substitute decision maker without the patient’s/client’s consent. Also, it is important to remember that subsection 241(a) of the Criminal Code continues to make it a criminal offence to “counsel” a person to commit suicide. Therefore, RRTs must not encourage, recommend or in any way influence a person to seek to end their own life.

In addition to the information provided here, the CRTO requires that its Members adhere to their organization’s policies (if applicable) with respect to the handling of inquiries from patients/clients regarding MAID.

The matter of conscientious objection is not addressed in the current federal legislation; the CRTO has guidelines in place for circumstances where an RT disagrees with the plan of care. If an RT finds that their beliefs and values are incompatible with MAID, the expectation of the CRTO is that the RT continue to provide the necessary care until it can be appropriately transferred to another health care provider. RTs are not obligated to assist in the implementation of a plan of care that they feel is not in the best interest of the patient/client. They are, however, responsible for ensuring that the patient/client is still able to receive the care they require and have consented to.

• • Government of Canada – Legislative Background: Medical Assistance in Dying (Bill C-14)
  • Supreme Court of Canada Judgements – Carter vs. Canada
  • Ontario Government – Medical Assistance in Dying and End-of-Life Decisions
  • College of Nurses of Ontario (CNO) – Guidance on Nurses’ Roles in MAID