Medical Assistance in Dying
Medical Assistance in Dying refers to a doctor or nurse practitioner helping a person, at their request, to end their life. The person must want to voluntarily and intentionally end their life.
Medical assistance can be in one of two ways. Either the doctor or nurse practitioner gives a medicine to the person that causes death, or they prescribe a medicine for the person to take themselves that causes death. For both ways, the doctor or nurse practitioner is present for the death.
Deciding to have ‘medical assistance in dying’ is deeply personal. Anyone thinking about this should talk with their family, their loved ones, and/or anyone else who can support them through the process.
It is normal to have questions and the following information will help you explore the option of assisted dying and who is eligible.
Who is eligible?
You could be eligible for assisted dying if you check off all of these bullets below.
- I have a valid BC CareCard or BC Services Card.
- I am an adult (18 years or older).
- I am able to make my own decisions about my health.
- I have a serious and incurable illness, disease, or disability (‘a grievous and irremediable medical condition’).
- I suffer unbearably from my medical condition.
- My medical condition has advanced or declined to the point where it cannot be reversed.
- My doctors have told me I can expect to die in the near future.
- No one at any time is pressuring me or influencing me to choose to die.
- I understand what assisted dying means to me and my family.
- I can tell everyone what I want right up until the time I am assisted to die.
What if I think I am eligible?
If you have checked off all the boxes and want to find out more, talk to your doctor or nurse practitioner.
If your doctor or nurse practitioner does not personally agree with assisted dying, they do not have to help you. However, they must give your request to another doctor or nurse practitioner who can help you.
What are the steps to receive medical assistance in dying’?
1. Talk with others.
Talk with your doctor or nurse practitioner about your medical condition and interest in assisted dying. They will make sure you consider all the options for services and treatments instead of assisted death. You do not have to accept any of these, but you do need to consider them before you choose assisted dying.
Talk to your family, loved ones, and other people in your life who can support you.
2. Fill in a form.
Call Fraser Health at 604-587-7878 or email firstname.lastname@example.org for a ‘Patient Request Record’ form to complete.
Two people must witness you signing the form. These people cannot benefit from your death or be anyone in Fraser Health.
3. Be assessed.
Two different doctors or nurse practitioners assess you separately to make sure you are eligible for an assisted death and are capable of deciding. They must agree you meet all the criteria.
4. Take time to reflect.
By law, you must wait at least 10 days from the time of signing your request to when the assisted death happens. This gives you time to reflect on what you decided and make sure this is what you want.
The time could be shorter if your death is fast approaching or if you could soon lose your ability to tell others what you want.
Can I change my mind?
Of course! You can change your mind at any time. That is why we ask you a number of times if this is what you want. If you change your mind, no one will think less of you.
Where can assisted death take place?
Assisted dying can take place in your own home, in the hospital, or in a care home.
Will patients have to pay for the drugs used to perform assistance in dying?
Patients will have full coverage for medications used in assisted dying.
Can I request medical assistance in dying in advance of experiencing suffering or receiving a diagnosis?
Medical assistance in dying cannot be provided based on an advanced directive or Living Will, and can only be considered after a current written request is received. Then assisted dying can only be provided after two medical practitioners have determined that all of the eligibility criteria set out in the Criminal Code have been met. To be eligible for medical assistance in dying, the patient must be diagnosed with a grievous and irremediable medical condition and experience intolerable suffering.
Furthermore, in order to receive medical assistance in dying, a patient must be able to clearly communicate their consent at the time of the procedure. Only the patient can request and consent to medical assistance in dying. Medical assistance in dying cannot be provided at the request of a substitute decision maker.
Where can I get more information about medical assistance in dying?
Call Fraser Health at 604-587-7878 or email email@example.com
Other options for end-of-life care
Information on other services for people nearing the end of life is available in our Palliative Care section.
For more information and background on medical assistance in dying in Canada, see:
- Government of Canada information on medical assistance in dying
- Guidance from the College of Physician and Surgeons of B.C.
- College of Physicians and Surgeons of B.C. - Medical Assistance in Dying FAQs
- Guidance from the College of Registered Nurses of B.C.
- Guidance from the College of Pharmacists of B.C.
- Federal Bill C-14: Medical Assistance in Dying
- B.C's Guidelines for Prosecutors
- The Supreme Court ruling Carter v. Carter
October 3, 2016:
Recently it has come to our attention that there is a belief that Fraser Health will be making a decision on whether or not this service will take place in a hospice/palliative care setting. The board is discussing the matter and will receive an update at the October board meeting on how we are currently providing care, but no decision will be made at that time.
The new federal legislation states no person will be forced to provide or help to provide medical assistance in dying, recognizing that not all health care providers will be comfortable with giving or helping to provide this service.
Our priority is supporting patients and responding to their needs as best we can. We will work in partnership with our patients and their families to determine how to best support their requests.
We are in discussions with our internal stakeholders and while they evolve, we will continue to provide patient-centered care including medical assistance in dying services as outlined in the legislation. When possible, we will provide the service where the patient is located, be it in acute care, home residences or community settings.
We recognize the concerns of some members of the palliative care team and hospice societies who feel assisted dying may conflict with a core philosophy of palliative and end of life care — to alleviate suffering as the patient reaches their natural death.
We are committed to a respectful approach that recognizes the diverse needs of patients and health care providers who find themselves in an ethical, moral and/or religious dilemma, while ensuring appropriate access for a legal health care service for our patients.