We’ve frequently blogged about Medical Assistance in Dying (also known as MAID). It is, in simple terms, assisted suicide. The usual method is a dose or injection of barbiturates. It is said to be quick, effective, and painless.

The act of committing suicide was a criminal act in Canada before the 2015 Supreme Court of Canada’s decision in Carter v. Canada. The Canadian parliament amended the Criminal Code as a result. It allowed physicians, and in some provinces, Nurse Practitioners, to provide medical assistance in dying but only in accordance with the rules set out in the amended Criminal Code.

In addition, any provincial or territorial health-related laws, rules and policies must be followed. Any assistance provided by the designated health professionals while following the prescribed procedure was expressly made a non-criminal act.

Those potentially able to provide medical assistance in dying were not forced to do so. Further provincial and territorial governments had the responsibility for determining how and where the assistance is provided so long as it does not contravene the Criminal Code provisions.

Who is eligible for medical assistance in dying?

In order to be eligible for medical assistance in dying, you must meet all of the following criteria. You must:

  • be eligible for health services funded by the federal government, or a province or territory;
  • be at least eighteen (18) years old and mentally competent;
  • have a grievous and irremediable medical condition;
  • make a voluntary request for medical assistance in dying that is not the result of outside pressure or influence;
  • give informed consent to receive medical assistance in dying.

Paediatric MAID

Most of us can imagine MAID applying to the elderly and frail, or to adults who are severely ill. However, it is available to anyone over the age of eighteen, which is the beginning of adulthood in many provinces. The thought of such individuals seeking MAID without parental consent or involvement will no doubt be of great concern to many.

The law in most provinces already allows mature minors to make decisions about their own care, including withdrawing or withholding life support. In Ontario, a minor is considered “capable” of providing consent if he or she has the maturity and intelligence to make a decision about the treatment and can appreciate the “reasonably foreseeable consequences” of their decision.

Medical Assistance in Dying at a Paediatric Hospital

Recently, Toronto’s Hospital for Sick Children developed a discussion paper (policy) on MAID for its patients eighteen (18) years and older. The policy may also potentially apply, down the road, to minors below the age of eighteen (18) who wish to seek MAID.

The hospital currently has physicians who are willing to use MAID for qualified youth eighteen (18) years and older. These physicians oppose having to transfer such patients to an unfamiliar adult hospital for MAID to occur. The physicians do currently regularly experience and encourage parental involvement in the process but do see the possibility of paediatric patients wishing that their families not be involved or even notified.

The report (draft policy) comes as a result of the federal government commissioning a panel of experts (bioethicists, palliative care physicians etc) to explore extending MAID to mature minors. It is currently legal to do so in some European countries. Canada is reviewing the issue and the Canadian Council of Academics is due to report to the federal parliament on the medical consensus about extending MAID to minors and in other cases currently prohibited.

The subject matter is clearly emotional and likely to generate significant political, religious and ethical debate. The Hospital does not name the health care professionals involved in assisted dying or any person working in the study group.

We will continue to follow developments in this matter, and will blog about updates as they become available.

At Wise Health Law, we focus on health and administrative law. We assist health professionals, health organizations, and national and provincial health professional associations to find solutions to their legal and regulatory issues. For the convenience of our clients, we have offices in both Toronto and Oakville, Ontario, and are easily accessible. Contact us online, or at 416-915-4234 for a consultation.

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