What is MAiD?

Getting the Facts

In February 2015, the Supreme Court of Canada determined that the total criminal prohibition of Medical Assistance in Dying (MAiD) did not align with the constitutional rights of Canadians. Ultimately, the Court decided that MAiD should be legal for Canadian patients who meet specific eligibility criteria, and left it to the government to develop an appropriate and reasonable legislative framework. In June 2016, the Federal government passed Bill C-14 into law, and MAiD became a legal end-of-life option for adult patients with serious illnesses and unbearable suffering.

In introducing Bill C-14, the Federal government clarified exactly which Canadians could be eligible for MAiD, and the process they would be required to undertake to gain access. Specifically, patients must:

Be eligible for health services funded by a government in Canada
Be at least 18 years of age
Be capable of making their own decisions
Have a grievous and irremediable medical condition
Have made a voluntary request for medical assistance in dying that, specifically, was not made as a result of external pressure
Provide informed consent to receive medical assistance in dying, after having been informed of the means that are available to relieve their suffering, including palliative care

In terms of defining a “grievous and irremediable medical condition”, the law states that the patient must meet the following criteria:

They have a serious and incurable illness, disease or disability
They are in an advanced state of irreversible decline in capability
That illness, disease or disability, or that state of decline causes them enduring physical or psychological suffering that is intolerable to them, and which cannot be relieved under conditions they consider acceptable
Their natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining.

Both physicians and nurse practitioners are able to provide MAiD, either through direct administration or prescription of medications. Patients must make a written request for MAiD, and then be assessed by two independent medical practitioners (physician or nurse practitioner.) The law also requires a ten-day waiting period between the date of the request, and the date that MAiD is provided, although this waiting period can be shortened under exceptional circumstances.

Bill C-7 was tabled by the federal government in February 2020 in response to a landmark ruling in Quebec. It received Royal Assent on March 17, 2021.

Under this new legislation,

Canadians no longer must have a reasonably foreseeable death in order to be eligible for medical assistance in dying;
There are now two sets of safeguards in place: One for those whose death is reasonably foreseeable, and one for those who death is not reasonably foreseeable;
Canadians with a reasonably foreseeable death, who have been assessed and approved for medical assistance in dying, but risk losing the capacity to consent prior to the MAiD procedure, will be able to sign a waiver of final consent;
During the two-year mental illness exclusion, the Government of Canada will hear from experts and develop safeguards and protocols for people who seek access to MAiD, but whose sole underlying medical condition is a mental illness.

You can read more about Bill C-7 here.