Medical Assistance in Dying (MAID): Know what to expect For patients accessing MAID at UHN and their caregivers Read this resource to learn: What the steps are for getting MAID at UHN What to expect of the MAID procedure How to prepare yourself and your loved ones for MAID What to expect as a caregiver of a patient getting MAID Please visit the UHN Patient Education website for more health information: www.uhnpatienteducation.ca 2017 University Health Network. All rights reserved. This information is to be used for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment. Please consult your health care provider for advice about a specific medical condition. A single copy of these materials may be reprinted for non-commercial personal use only. Author: Department of Supportive Care Created: 11/2017 Form: D-8663
The process for getting MAID has a few steps. It can take about 2 weeks from your formal written request to receive MAID. Step 1: Speak with your doctor Tell your doctor that you want to get MAID. Your doctor will: Talk to you about why you would like MAID and give you information about the procedure. This will help you decide if you want to make a formal request for MAID. Talk to you about your medical condition. This includes your chance of recovery and the options available to you to help relieve your suffering. Explain the criteria for MAID and the process for getting it at UHN. If you decide to pursue MAID at UHN, your doctor will give you a form to complete called, Patient MAID Request. Step 2: Complete a formal written request The Patient MAID Request Form is a formal written request for MAID. You will need to sign this form in front of 2 separate witnesses. This is the law. Your witnesses must sign the form the same day you do. Your 2 witnesses must meet the following criteria: They are over the age of 18 They will not benefit from your estate They do not own the health care facility you are in They do not provide direct personal care or health care to you Witnesses usually cannot be family members or any UHN staff person. 2
Step 3: Be assessed by 2 doctors After you have made a formal written request for MAID, the following will occur: You will have separate assessments with 2 doctors. Each assessment will last about 1 hour. The assessments may or may not happen on the same day. The doctors will speak with you to assess if you are capable of making health care decisions and giving informed consent. They will make sure that the decision to get MAID is your own and that you are not under any pressure from others. The doctors will also review your medical records. They will see if you have a serious and incurable illness that will result in your reasonably foreseeable death (death will occur in the near future). Following the assessments, you will be given a letter of the doctors decision. This includes next steps. Step 4: Wait through a reflection period This waiting period is time for you to think about your decision carefully and to be sure it is right for you. The reflection period starts from the day you submit your written request for MAID. It is 10 days as required by law. In some cases, the assessment doctors may shorten or lengthen the reflection period. This depends on your condition and if you may no longer be able to provide informed consent. 3
Step 5: Schedule MAID You must call the MAID coordinator at least 3 working days before you want to receive MAID. The MAID coordinator will arrange for you to meet the doctor who will perform the MAID procedure. The coordinator will also talk to you about: The time of your procedure The location of your procedure Any special requests you may have about the setting for MAID You must be mentally capable of giving informed consent at the time you receive MAID. Patients who want to receive MAID may be able to donate their organs and/ or tissues. All patients will be referred to the Trillium Gift of Life Network to discuss organ and tissue donation, if eligible. Remember: You have the right to change your mind at any time. What can I expect of the MAID procedure? MAID is given by a doctor who provides the medications by intravenous (IV) injection. The procedure will take place in a private room in the hospital. MAID is a fairly painless procedure. You will become unconscious within a few minutes of the injection. The entire process generally takes about 10 minutes to complete. Your health care team will be there to support you and your loved ones. You will need to provide informed consent just before you receive MAID. 4
To prepare yourself for MAID You may wish to talk with the MAID Coordinator about what you can do to prepare for MAID. This includes: Who you want to be present at your death. Based on your wishes, your family, pets and others can be in the room during MAID. What special arrangements, such as music, clothing, food or any bedside ceremonies you would like at your death. The hospital will try to accommodate personal, cultural and religious preferences. How to make sure your affairs are in order before getting MAID. This may include saying goodbye to your family and/or friends, making your own funeral arrangements, or making sure your Will is up to date. How to choose a funeral home To prepare your loved ones (family and friends) for your death Talking to your loved ones about your decision to have MAID is a personal choice. You may choose to discuss your wish to receive MAID, or you may choose to keep your plans private. However, discussing it with your loved ones may help them to understand why you want MAID and the MAID process at the hospital. This may help your loved ones feel better prepared for your death. If you are concerned about your loved ones ability to cope with your decision and death, support is available. Please speak to your doctor about a referral or list of resources for family and friend support. 5
Information for Caregivers: What to Expect How can I prepare myself for MAID? It is hard to know how to prepare for MAID. Ask questions of the doctor or nurse who will be helping on the day. If you need extra support, speak with the nurse. They can contact a member of the MAID Supportive Care Team to help you. Will I have time with my loved one s body after MAID? You will have time with your loved one s body when the MAID procedure is complete. Do not move the body of your loved one or remove anything until a team member tells you it is okay. What supports are available to me after the death of my loved one? The MAID Supportive Care Team or your loved one s regular health care providers will offer you emotional and practical support following the death. For more information, please ask a member of your health care team. 6