On June 17, 2016, the federal government enacted legislation allowing for the provision of medical assistance in dying in certain circumstances in Canada. On March 9, 2017, CARNA provincial council approved the documents:
In December 2016, the NP Medical Assistance in Dying Standards of Practice were approved through an Order in Council under the authority of the Minister of Health.
These documents provide guidance for NPs and RNs about their responsibilities and accountabilities related to medical assistance in dying.
On June 17, 2016, The Act passed Royal Assent and became law, allowing a person to request and receive medical assistance in dying in Canada under limited circumstances. This legislation revises the Canadian Criminal Code to include exemptions from otherwise applicable criminal offenses for health-care providers who help to provide medical assistance in dying in defined circumstances.
The Alberta Health ministerial directive D3-2016 outlines that Alberta Health Services (AHS) shall coordinate and facilitate access to health services relating to medical assistance in dying in Alberta. Anyone that is seeking additional information related to medical assistance in dying may be referred to their physician, nurse practitioner or can contact Health Link at 811 or contact the AHS Medical Assistance in Dying Care Coordination Team at MAID.CareTeam@ahs.ca.
The amended Criminal Code of Canada allows nurses to participate in medical assistance in dying when aiding a physician or nurse practitioner. It is essential for nurses to understand that they will have a limited role in medical assistance in dying. Only a physician or nurse practitioner may administer the substance that causes the death.
For more information and guidance on the RN role in medical assistance in dying, please see our collaborative document Medical Assistance in Dying: Guidelines for Nurses in Alberta.
We have collaborated with Alberta Health, Alberta Health Services, the College of Physicians and Surgeons of Alberta, and the Alberta College of Pharmacists to develop a regulatory framework for medical assistance in dying (MAID) that is aligned, legally sound, safe and consistent with the amended Criminal Code of Canada. This framework includes additional provincial safeguards for consistency and patient safety.
RNs and NPs considering involvement in medical assistance in dying can contact us at email@example.com for practice advice and/or can contact the Canadian Nurses Protective Society at 1.800.267.3390 for liability advice.
Nurses are not required to participate in medical assistance in dying if it is in conflict with their moral beliefs and values. The amended Criminal Code of Canada does not impose any obligation for NPs or nurses to participate or aid in medical assistance in dying.
If you are asked to aid in any aspect of lawful medical assistance in dying and choose not to participate due to personal moral beliefs and values, lack of skill or other reasons, you must immediately:
No personal moral judgments about the beliefs, lifestyle, identity or characteristics of the client should be expressed by the nurse. Until alternative care arrangements are in place to meet the client’s needs or desires, a nurse must continue to provide nursing care, as per a client’s care plan, that is not related to activities associated with medical assistance in dying.
The issue of ending life raises many ethical considerations and generates differences of opinion. Because clients may make choices that challenge or conflict with the moral values of health professionals who care for them, it becomes necessary to recognize the rights of all persons with conflicting views with the care team. Nurses need to respect their own moral beliefs while at the same time respecting the moral beliefs of others.
If you have any questions about this, please contact firstname.lastname@example.org.
Acknowledge the request for information in a competent and compassionate way. Know that your client’s request for additional information or further consultation on medical assistance in dying is their constitutional right and we can support their access to accurate and objective information so that they may make an informed decision about their care.
Whether or not a nurse chooses to participate in medical assistance in dying, they have an obligation to: