1

Medical Assistance in Dying (MAID)

Unfocused photo of person in a hospital bed

In mid-March, the federal government passed legislation to expand access to Medical Assistance in Dying (MAID) to individuals whose natural deaths are not reasonably foreseeable.

CPSO updated its Medical Assistance in Dying policy to reflect the legal framework changes that resulted from the passage of Bill C-7.

The most significant change in Bill C-7 is it is no longer necessary for an individual’s natural death to be reasonably foreseeable for them to be eligible for MAID. Instead, whether an individual’s natural death is reasonably foreseeable now determines which of the two procedural safeguards apply:

Existing safeguards have been maintained or eased for individuals whose natural death is reasonably foreseeable, including reducing the number of independent witnesses required to sign the individual’s written request and eliminating the 10-day reflection period.

New and strengthened safeguards have been established for individuals whose natural death is not reasonably foreseeable, including requiring individuals be informed of available and appropriate means to relieve their suffering, and offered consultations with professionals who provide those services. It also requires individuals undergo a 90-day assessment period before receiving MAID.

To reflect the new legal framework, the following key amendments were made to CPSO’s policy:

  • Deleting the requirement that an individual’s natural death be reasonably foreseeable and adding the exclusion of mental illness as the sole condition that makes an individual eligible for MAID. (This exclusion will stay in place until March 17, 2023, at which time it will be repealed).
  • Adding the new circumstances where patients can enter into a written arrangement that waives the requirement that the MAID provider obtain their final express consent immediately prior to the patient receiving MAID.
  • Updating procedural safeguards for MAID to reflect the new two-track approach.
  • Adding the requirement to report an eligibility assessment, including a preliminary assessment of whether a patient meets the eligibility criteria.

The MAID policy is being reviewed as part of the regular policy review cycle and is currently out for preliminary consultation. More substantive policy revisions will be proposed in the context of the review.