Medical Assistance in Dying

Medical Assistance in Dying (MAiD) is a process by which a patient chooses to end their life with the help of a doctor or nurse practitioner. It is a medical procedure during which a patient is given medications to intentionally and safely end their life. Federal laws set the rules for who can use MAiD and how it must be done.

People who apply for MAiD must:

• Be 18 years of age or older and be eligible for publicly funded healthcare in Canada.
• Have a serious and incurable illness, disease or disability.
• Be in an advanced state of decline that cannot be reversed.
• Be capable of making health-care decisions for themselves and have all the information they need to make informed decisions about their illness, all available treatments and options to help with their suffering, including palliative care.
• Be experiencing intolerable physical or mental suffering from their condition.
• Make a voluntary and witnessed request, in writing, for MAiD.

It means that you must understand and remember information to make decisions about your medical treatment. You also must be able to consider what might happen because of your decisions. If you are at risk of losing capacity because of your medical condition, your MAiD assessor will discuss options available to you.

MAiD is not a last-minute or rushed process. It can take several days or weeks to go through all the necessary steps. If you are likely to die very soon, there may be other end-of-life care options that may be better suited for you than MAiD. 

There are two pathways for patients. The first pathway or Track 1, applies if you have a Reasonably Foreseeable Natural Death (RFND). The second pathway or Track 2, applies if there is no Reasonably Foreseeable Natural Death (no-RFND). The track that applies to your situation will be determined by the MAiD assessors.

Step 1: Written request

You must ask for MAiD in writing. In Ontario, there is an official form for this. Your signature must be witnessed by one person who must sign the document at the same time as you. Your witness must be 18 years of age or older and cannot be named in your will or benefit from your death in any way. The witness cannot own or be in charge of the healthcare facility where you live or get treated. They also cannot be your MAiD assessor or provider.

Step 2: Assessments of eligibility

You will have at least two separate assessments to find out if your request can be approved for MAiD. You may also need assessments by other healthcare professionals to determine if you can have MAiD. Both MAiD assessors must agree that you can be approved for MAiD. Each assessment can take up to one to two hours.  

Assessments include: 

• A review of your medical history and current medical situation.
• A discussion about treatment options and available supports.
• An assessment of your ability to make decisions.
• A detailed explanation of the MAiD process including which pathway you will follow based on your medical condition.
• An opportunity to answer any questions you or your loved ones may have.

Step 3: Possible waiting period

People who are approved for MAiD under Track 1 do not have a waiting period. For people who are approved for MAiD under Track 2, at least 90 days must pass between their first assessment and when MAiD can be provided.

Step 4: Provision of MAiD  

If you have been approved for MAiD and decide to go ahead, your MAiD team will create a detailed plan with you. The following information may be helpful to think about:  

• The date, location, who you would like present and any special arrangements you would like.
• You will need to make funeral arrangements, and ensure your will is up to date.
• You might want to consider if organ and tissue donation is something you would like.

In Ontario, the Office of the Chief Coroner must be notified of all MAiD procedures. Someone from the coroner’s office will ask to speak to your next of kin a few days after MAiD has taken place.

Yes. You can change your mind at any time, for any reason. Simply tell your doctor, nurse, or health professional helping you with MAiD that you do not wish to continue with MAiD.

Not necessarily. The MAiD assessors will make sure that you are aware of all the options to relieve your suffering, including counselling services, mental health and disability support services, community services and palliative care.

Based on changes to the MAiD law, people with mental illness as their only medical condition causing suffering are not allowed to have MAiD. This exclusion to the law remains valid until 2027. This will allow the Government of Canada more time to consider how MAiD can safely be provided to those whose only medical condition is mental illness. 

No. MAiD will not affect life insurance or pensions.

Health-care providers have the right to refuse to participate in MAiD based on their personal beliefs. In this case, they must refer you to someone who can help with your MAiD request. 

If you are not eligible for MAiD, your family doctor and/or your health-care team will continue to care for you and support you as they normally would.