Canada’s Legalization of Medical Assistance in Dying

A Message From…
Raman Mahabir, MDRMahabir
PSEN Co-Editor

Dear Colleagues,

In late June, the Canadian Senate passed a bill (Bill C-14) on medical assistance in dying (MAID).  The new legislation on MAID will become part of the Criminal Code, which is made by the federal government.  It states that medical assistance in dying is not a criminal offence when it is provided according to the conditions and safeguards in the law.  Provinces and territories (similar to state level) must follow this new criminal law. However, they can create their own health-related laws or additional rules, so long as they are consistent with what is in the criminal law.

The intent of this national framework is to provide consistency and clarity around MAID eligibility and who can administer this procedure. This is an extremely personal and complex issue.  As such, legislation does not force any person to provide or help to provide medical assistance in dying.  No provider will be forced to practice MAID if it goes against his or her moral compass.  Medical assistance in dying is only one aspect of end of life care.  There is also a need for palliative care services to be accessible to all Canadians so MAID isn’t the only choice for patients.

Physicians in Canada belong to the Royal College of Physicians and Surgeons (Canada).  That organization (and I am proud to say I am a member) has as its vision: “The best health for all, the best care for all.”  The Royal College has started a national education campaign on this topic, including bio-ethics and workshops for residents, and will also continue to work with its partners to determine how best to prepare doctors for the implementation of MAID.  They also plan to consult and collaborate with national specialty committees, national specialty societies, national and provincial regulatory authorities, the Canadian Medical Association, the College of Family Physicians of Canada (CFPC), medical schools and other organizations to respond to ongoing legislative developments.

This is a significant development in the practice of medicine.  My hope is that we can begin to have discussions around this important topic on this side of the border, as well.