Medical Assistance in Dying M.A.I.D.

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Presentation transcript:

Medical Assistance in Dying M.A.I.D. Marilyn Gladu Jan 2019

Topics History in Canada- the Carter Decision C-14 Palliative Care Consultations on Advanced Consent, Minors and those suffering mental disorders History Elsewhere- Its not that simple

History in Canada 50 years of discussion The Carter decision 2015 C14 Palliative Care Bill C277 Outcomes ( Sarnia 2, London 300, nationally ~ 4000)

Advanced Consent- 3 issues How to prove it is informed consent The third party responsible to enforce the decision- what if there is disagreement Who decides what is intolerable suffering when the person has lost capacity Belgium and Luxembourg only allow when a person is permanently unconscious

Mature Minors No definition nationally 14-17 in Quebec For informed consent, need capacity to make a medical decision, to be provided information in a way that facilitates understanding, and to make a voluntary choice free from duress or coercion Netherlands allows 12-16 with parental permission, 16-18 parental consultation Belgium must be terminal, and must provide pediatric palliative care as option

Mental disorders – Very Controversial Working group on study could not agree Capability for informed consent Concern for MAID where death is not reasonably foreseeable that you could get better and change your mind How to differentiate those that want to commit suicide as a symptom of their mental disorder Netherlands allows for dementia, but with much controversy

Palliative Care Where quality palliative care exists, 95 % of people choose to live as well as they can for as long as they can Palliative Care Framework World Health Organization Definition Difference from M.A.I.D.