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Medical aid in dying

Medical aid in dying is an exceptional intervention available to end-of-life patients who meet certain specific criteria and who ask for it. It consists of a doctor administering medications in order to relieve the patients’ suffering by bringing about their death. The use of this intervention is governed by strict guidelines set out in the Act.

How can a patient access medical aid in dying?

Only a person who meets the following criteria may obtain medical aid in dying:

  • Be at least 18 years of age
  • Be capable of giving consent to care
  • Be insured under the Régime de l’assurance maladie du Québec (RAMQ)
  • Be at the end of life
  • Suffer from a serious, incurable illness
  • Be in an advanced state of irreversible decline in capability
  • Experience constant and unbearable physical or psychological suffering that cannot be relieved in a manner the person deems tolerable.

Where can I obtain these services?

End-of-life care, i.e., palliative care and medical aid in dying, can be obtained:

  • in institutions of the health and social services network (hospitals and residential and long-term care centres – CHSLD)
  • at home
  • in palliative care centres

However, each institution or palliative care centre has an end-of-life care policy which outlines the nature and extent of the care it provides. End-of-life patients and their loved ones should review this policy before choosing a care site.

Procedure

To initiate medical aid in dying administration, the user must:

  1. Submit a request for information on medical aid in dying from a health professional
  2. Make a formal verbal request to a health and social services professional in the presence of 2 independent witnesses
  3. Submit a written request using the Request for medical aid in dying form, available from a health professional
  4. Sign the form in the presence of a health professional and 2 independent witnesses
  5. Repeat the verbal request in every discussion with the doctor

End-of-life patients are supported by:

  • The attending physician
  • A multidisciplinary team of health and social services professionals (e.g., nurses, social workers, etc.)

What should I expect?

Following the procedure initiated by the patient, an eligibility assessment process will be launched, and the patient, along with his loved ones, where applicable, will be supported by the attending physician throughout the procedure. Signing the Request for medical aid in dying form does not automatically guarantee acceptance of the request. After the form has been signed, an eligibility verification process is launched, and if the end-of-life patient meets the medical aid in dying criteria, his attending physician will then be required to get the opinion of a second physician.

 

It should be noted that a patient making a request for medical aid in dying is free to change his mind at any time. The patient can thus withdraw his request for medical aid in dying or request its postponement.

Throughout the procedure, the attending physician (and the other health and social services professionals) will be available to answer questions from the end-of-life patient and his loved ones. The attending physician will also discuss other care avenues available as well as the challenges associated with the procedure.

Procedure

  • There must be 10 days between the time of the request for medical aid in dying and the moment it is administered.
  • On the day medical aid in dying is administered, the patient will be transferred to a private room to ensure an appropriate and peaceful environment.
  • Before medical aid in dying is administered, the physician will carry out a final validation of compliance with the Act, as well as the patient’s desire to pursue his request.
  • The physician will remain with the patient until death.
  • Support will be provided to the patient’s loved ones following his death.