Medical Assistance in Dying (MAID) at UHN For patients and caregivers who want to know more about MAID at UHN. 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: 1/2017 Form: D-8665
Adults in Canada who are near the end of life now have the right to request Medical Assistance in Dying, or MAID. Who is eligible for (able to get) MAID? To be eligible for (able to get) MAID a person must: Be at least 18 years old Be eligible for (able to get) government funded health insurance in Canada (for example, OHIP) Be able to make health care decision Have a serious and incurable illness (illness that cannot be cured) that causes intolerable suffering (suffering that a person can no longer bear) Be in an advanced state of decline where death is reasonably foreseeable (death will occur in the near future) Make a request for MAID freely and without pressure from anyone else Give informed consent to get MAID A person cannot: Request MAID for a future time when they may become incapable (unable to make healthcare decisions) Have their family, lawyer or substitute decision maker request MAID for them 2
Why would a patient consider MAID? End of Life choices are very personal decisions. However, there are some common reasons why patients request MAID. Some patients may: Want to be free from pain and suffering Want control over when and how death occurs Want to avoid poor and declining quality of life Not want palliative sedation. Palliative sedation involves giving medication that makes someone no longer feel pain or discomfort. This makes someone less aware and less conscious Who does a patient talk to in order to learn more about MAID? A patient can speak to any member of their health care team to know more about MAID. This person might be someone who the patient is comfortable with and trusts. It may be the patient s nurse, doctor, social worker, spiritual care provider or other member of the team. To get MAID, a patient must get a referral from their doctor. Who does a patient speak with if they are worried that their health care provider is against MAID for moral, religious or other reasons? All hospital staff must respond to questions about MAID in a respectful way. Doctors who are uncomfortable with MAID will refer their patients to other doctors who can help with next steps. If a patient does not feel at ease talking to members of their health care team about MAID they can request a confidential consultation (private meeting) with a member of the Bioethics team. This can be done by calling the Director of Bioethics at 416-340-4800, extension 8607. A bioethicist is someone who supports patients and family members dealing with ethical issues in a patient s care. 3
How can a patient access MAID at UHN? There are a few steps a patient must go through to access MAID. These steps include: Speaking with their doctor and making a formal written request for MAID Being assessed by 2 doctors Waiting a minimum period of time decided by the doctors and required by law for the patient to be sure of his or her decision Meeting with the doctor who will provide MAID These steps can take about 2 weeks to complete. What are the financial and insurance impacts of MAID? All MAID services and medications are covered by Ontario health insurance (OHIP). Insurance companies have agreed not to withhold insurance benefits for deaths due to MAID. The Coroner s Office will work with families on insurance claims. What safety measures are in place to protect patients? Patients decisions to have MAID must be their own. Patients must be assessed by two separate doctors to make sure that they meet the eligibility criteria. The health care team will take measures (such as, having interpreters available) to ensure the patient can understand the information and communicate their decision. 4
Patients must sign a formal written request in front of two separate witnesses. The witnesses usually cannot be family members or health care providers. There is a mandatory waiting period between the time of the patient s request and the day that MAID is provided. Patients can withdraw their requests at any time. Just before getting MAID, the patient must be able to provide informed consent. How will patients and caregivers be supported through MAID? Patients and families can continue speaking with a member of their health care team for help through the MAID process. Patients may be referred for specialized physical and emotional support, as well as continue receiving general medical care, through their doctor. After a patient has received MAID, the MAID team or the patient s health care providers will continue to offer emotional and practical support to family members as needed. For more detailed information about MAID, read the pamphlet called Medical Assistance In Dying (MAID): Know what to expect. The development of patient education resources is supported by the Princess Margaret Cancer Foundation. 5