MAID al­ter­ations could still be a year away, panel says

Medicine Hat News - - FRONT PAGE - GIL­LIAN SLADE gslade@medicine­hat­ Twit­ter: MHNGil­lianSlade

A “rea­son­ably fore­see­able” death is one of the re­stric­tions for med­i­cal as­sis­tance in dy­ing that has ex­perts scratch­ing their heads, and it could be an­other year be­fore we know if it will be changed, an au­di­ence was told at a Friends of Medi­care event.

It is not a le­gal def­i­ni­tion, said Dr. Dionne Walsh, med­i­cal lead for MAID AHS south zone.

“It’s an ex­traor­di­nar­ily vague term,” said Dr. David Amies of Dy­ing with Dig­nity Canada.

When it comes to ad­vance di­rec­tives for MAID, Amies thinks this will be ac­cepted in the fu­ture with con­sid­er­able change in the next five years.

An in­quiry is to sub­mit a re­port to the fed­eral gov­ern­ment by 2018, said Amies. The re­port will not need to be made pub­lic though.

“I find that a lit­tle bit sneaky,” said Amies.

Since Feb. 6, 2016, when court or­ders made med­i­cally-as­sisted death pos­si­ble, there have been 85 deaths in Al­berta, of which 10 were is the south zone. Six deaths oc­curred be­fore June 17, 2016, when fed­eral leg­is­la­tion re­moved the need to at­tain a court or­der, ac­cord­ing to AHS data.

A to­tal of 48 did not met the fed­eral cri­te­ria for MAID and these in­clude a men­tal health di­ag­no­sis, loss of ca­pac­ity or com­pe­tency and death not be­ing rea­son­ably fore­see­able.

The most cited health con­di­tions for some­one re­ceiv­ing MAID has been can­cer, mul­ti­ple scle­ro­sis and amy­otrophic lat­eral scle­ro­sis (ALS), ac­cord­ing to AHS data. The aver­age age of peo­ple re­ceiv­ing MAID has been 65 in the south zone, 73 in Cal­gary, 88 in cen­tral zone, 67 in Ed­mon­ton and 63 in the north zone.

MAID is de­fined as “the ad­min­is­ter­ing by a med­i­cal prac­ti­tioner or nurse prac­ti­tioner of a sub­stance to a per­son, at their re­quest, that causes their death,” ac­cord­ing to an AHS doc­u­ment. It in­cludes med­i­cal or nurse prac­ti­tion­ers pre­scrib­ing or pro­vid­ing a sub­stance, at the re­quest of a per­son, so they may self-ad­min­is­ter and in so do­ing cause their own death.

The pa­tient’s el­i­gi­bil­ity, un­der fed­eral gov­ern­ment leg­is­la­tion, in­cludes be­ing at least 18 years old with full de­ci­sion­mak­ing ca­pac­ity, in­clud­ing right be­fore the ad­min­is­tra­tion of the sub­stance. The ill­ness must be in­cur­able and ir­re­versible with en­dur­ing phys­i­cal or psy­cho­log­i­cal suf­fer­ing, the AHS doc­u­ment says. Nat­u­ral death must be rea­son­ably fore­see­able. The re­quest must be vol­un­tary with in­formed con­sent, and the per­son must be el­i­gi­ble for pub­licly funded health-care ser­vices in Canada.

While Covenant Health has been noted for not al­low­ing MAID in its fa­cil­i­ties, there have been three other non­faith based fa­cil­i­ties that have taken the same stand, said Nancy Camp­bell, MAID co-or­di­na­tor AHS south zone. The con­ver­sa­tion is on­go­ing in this re­gard and some will now al­low the as­sess­ments of pa­tients for MAID to take place in the fa­cil­ity.

Af­ter MAID the body is sent to the med­i­cal ex­am­iner in Cal­gary, who sup­plies the death cer­tifi­cate, be­fore be­ing re­turned to loved ones. The med­i­cal ex­am­iner looks at all the pa­per­work to en­sure the cor­rect pro­ce­dure has been fol­lowed, said Camp­bell.­ber­ta­health­ser­ /info/page13497.aspx

You can also call Health Link 811 for more in­for­ma­tion.


A panel an­swers ques­tions about Med­i­cal As­sis­tance In Dy­ing at a Friends of Medi­care event on Wed­nes­day. From left: Dr. David Amies, Dy­ing with Dig­nity Canada; Nancy Camp­bell, MAID co-or­di­na­tor AHS south zone; Colin Zieber, ex­ec­u­tive di­rec­tor se­niors health and op­er­a­tional lead MAID AHS south zone; and Dr. Dionne Walsh, med­i­cal lead for MAID AHS south zone.

David Amies

Dionne Walsh

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