Week 7 - MAiD Flashcards
Which bill legalized MAiD?
Bill C-14
Definition of MAiD
(a) the administration by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death; or
(b) the prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request, so that they may self-administer the substance and in doing so cause their own death. (Bill C-14, 2016)
What is euthanasia? Types?
Practice of performing an act to end the life of another person; usually to relieve pain and suffering
Active - Directly & deliberately act to cause to cause a person’s death (ex. giving them a substance)
Passive - withholding life-preserving measures/treatment
Voluntary - person requested it
Involuntary - Pt does not have decision making capacity; done at the request of someone else responsible for the patient, such as: family member,
What is assisted suicide?
Intentionally killing oneself w/ the assistance of another person
- Ex. person provides you w/ the knowledge and means
- sometimes caused by bullying
What is physician-assisted suicide? How is it different from physician-assisted euthanasia?
Dr. knowingly & intentionally provides someone with the knowledge to kill themselves
Physician-assisted euthanasia - Intentionally participates in the death of a patient, by directly administering the substance causing death or showing them how to administer it to themselves
What is the criteria for MAiD?
1) Applicable minimum period of residence or waiting period, would be eligible – for health services funded by a government in Canada
2) 18 years and older & capable of making decisions with respect to health
3) Have a grievous & irremediable medical condition
4) They have made a voluntary request for medical assistance in dying that, was not made due to external pressure
5) They give informed consent to receive MAiD after having been informed of the means that are available to relieve their suffering, including palliative care – while giving the option of MAiD, must also give the option of palliative care & document the option was provided
What are the current safeguards to MAiD
- Must sign a written request expressing their wish in front of 2 independent witnesses (10 days before the date of death)
2 physicians &/or NPs must independently confirm their written agreement that the patient has = an incurable, grievous, & irremediable medical condition
Who is ineligible for MAiD
- Minors
- Mental illness
- long-term disability
- any curable condition
What are the key changes of Bill C7?
Eligibility criteria:
- Removed: death is reasonably unforeseeable
Safeguards:
- eased where death is reasonably foreseeable
- removed the 10 day reflection period
- new safeguards for cases where death is not reasonably foreseeable
Advanced request
- waiving the final consent for some patients where death is reasonably foreseeable
- allowing advanced requests
What are the stages to getting MAiD ?
1) Determine eligibility Stage
2) Ensure safeguards are met Stage
3) Obtain consent Stage
4) Provide Medical assistance in dying – either by the NP or physician or self-administered by the patient.
The law defines a patient as having a grievous and irremediable medical condition only if:
1) They have a serious and incurable illness, disease or disability
2) They are in an advanced state of irreversible decline in capability
3) That illness, disease, disability or state of decline causes them to endure physical or psychological suffering that is intolerable to them and cannot be relieved under conditions that they consider acceptable.
How do we ensure safeguards for MAiD are met?
- Patient’s written request signed by one independent witness
- Confirmation of patient’s eligibility provided by two independent practitioners (NP or physician)
- informed that they can withdraw consent at any time
- All necessary measures are taken to provide a reliable means for patients with difficulty communicating to understand and communicate their decision.
- Immediately before providing medical assistance in dying, the patient is given an opportunity to withdraw their request and ensure that the patient gives express consent to receive medical assistance in dying
What is the CNA framework for MAiD?
1) provide compassionate, competent, and ethical care
2) Promote health and wellbeing
3) promote and respect informed decision making
4) preserve dignity
5) Maintain privacy and confidentiality
6) Be accountable
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