Medical assistance in dying
On June 17, 2016, medical assistance in dying became legal in certain circumstances in Canada. On Nov. 1, 2018, federal regulations were put in place for the monitoring of medical assistance in dying. The regulations address what information must be provided to Health Canada, and by when.
An Alberta Health ministerial directive outlines that Alberta Health Services (AHS) will coordinate and facilitate access to health services relating to medical assistance in dying in Alberta. The AHS Care Coordination Service is the point of contact for ALL reporting in Alberta.
For questions regarding reporting, please contact firstname.lastname@example.org.
Frequently asked questions
What are the requirements for RNs and NPs?
While RNs may participate in medical assistance in dying when aiding a physician or nurse practitioner, they must understand that they will have a limited role. Only a physician or NP may administer the substance that causes the death.
For more information and guidance on the RN role or conscientious objection, please see the collaborative document: Medical Assistance in Dying: Guidelines for Nurses in Alberta.
CARNA has collaborated with Alberta Health, AHS, the College of Physicians and Surgeons of Alberta, and the Alberta College of Pharmacists to develop a regulatory framework for medical assistance in dying 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.
Only physicians and NPs can assess a person’s eligibility for and provide medical assistance in dying. The eligibility criteria, safeguards that must be met, and the monitoring and reporting requirements are outlined in the following documents:
RNs and NPs with questions or are considering involvement in medical assistance in dying can contact CARNA at email@example.com for practice advice and/or can contact the Canadian Nurses Protective Society at 1.800.267.3390 for liability advice.
What if medical assistance in dying is against my beliefs or values?
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 registered nurses to participate in 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 conscientious objection, lack of skill or other reasons, you must immediately:
- Assure the client that they will not be abandoned and continue to provide care that is not related to activities associated with medical assistance in dying.
- Notify your employer so that alternative care arrangements can be made.
- Direct the client to their primary care practitioner or provide the contact information for the AHS Medical Assistance in Dying Care Coordination Service via email at MAID.CareTeam@ahs.ca.
In treatment and in care, nurses work with persons receiving care to take into account their values, customs and spiritual beliefs without judgment or bias.
The issue of ending life may raise ethical considerations and may generate differences of opinion. Because clients may make choices that challenge or conflict with the moral values of health professionals who care for them, it is necessary to recognize the rights of all persons with conflicting views within 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.
What do I say if a client wants information on or is seeking medical assistance in dying?
Honour the client’s 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:
- Openly discuss the client’s concerns, unmet needs, feelings, and desires about their care.
- Direct the client to their primary care professional or provide the contact information for the AHS Medical Assistance in Dying Care Coordination Service (MAID.CareTeam@ahs.ca) if unable to support their access to information.
Nurses must be mindful not to encourage or incite a client to seek medical assistance in dying.
What do the medical assistance in dying federal monitoring regulations do?
The federal regulations were put in place to establish a monitoring and reporting system for medical assistance in dying. The regulations address what information must be provided, how and when it must be provided, to whom, and its use and disposal. The information collected will be used to publish annual reports on medical assistance in dying in Canada, including the number of requests received, the number of medically assisted deaths and the number of people found ineligible.
AHS will act on behalf of the Medical Assistance in Dying Regulatory Review Committee in terms of collection of data and collation under the Ministerial Order within prescribed timeframes. The AHS Care Coordination Service is the point of contact for ALL reporting in Alberta.