Canada’s federal government should continue to proceed with caution on MAiD policy
2020-02-12 from cmaj.ca
by Andreas Laupacis MD MSc
The legalization of medical assistance in dying (MAiD) in June 2016 has been the most profound change in health care during my medical career. There is no more important and emotional time than someone’s death, and how some Canadians could choose to die was fundamentally changed overnight.
The legalization of MAiD has challenged us to ensure, above all, that patients’ wishes are fulfilled. At the same time, we have had to respect health care workers’ personal views about the practice and ensure that MAiD is offered only to those who meet the criteria identified in the federal legislation. In Canada, MAiD can be provided only to someone who is clear of mind at the time of death, has an illness from which death is reasonably foreseeable, and who states that they have intolerable physical or psychologic suffering despite access to treatments for that suffering.
Canada’s government is now considering whether to expand the criteria for access to MAiD. Therefore, Downar and colleagues’ analysis of the first 2241 medically assisted deaths in Ontario is timely.
The authors found that those who received MAiD were more likely to have cancer, be married and live in a wealthy neighbourhood than all people who died in Ontario.
Three-quarters of people who received MAiD were cared for by palliative care practitioners before their death. The 10-day reflection period before the procedure was shortened for 58% of those whose estimated prognosis was less than 1 month. Family or providers reported concerns about difficulties in accessing MAiD for 7% of deaths.
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