- What is medical assistance in dying?
- Who is eligible?
- How to start the process
- What is the process?
Talk with your health care provider about medical assistance in dying. They can provide information about palliative care and other end-of-life care options.
What is medical assistance in dying?
Medical assistance in dying provides the option to end a life with the help of a doctor or a nurse practitioner. At a patient’s request, a health professional can provide or administer medication. This medication intentionally ends a patient’s life. It's only for those with a serious and incurable medical condition.
Health professionals will provide respectful information on how to access this service.
In Canada, medical assistance in dying is legal as long as it follows federal laws. Doctors and nurse practitioners providing assistance must follow the Criminal Code. They must also follow all applicable territorial laws, rules and policies. Doctors must use the standards of the Yukon Medical Council. Nurse practitioners must adhere to standards of practice of the Yukon Registered Nurses Association.
All Yukoners living with incurable, life-threatening illness have access to other options. These options include palliative care. Palliative care aims to:
- relieve suffering;
- improve quality of life; and
- preserve a person's dignity throughout the natural dying process.
Who is eligible?
You can access medical assistance in dying if you're:
- eligible for the Yukon Health Insurance Plan or another public plan in Canada;
- at least 18 years of age and capable of making decisions about your health;
- making a voluntary request for medical assistance in dying that was not made as a result of external pressure;
- giving informed consent to receive medical assistance in dying (this means you made the decision knowing all available options to relieve your suffering, including palliative care services); and
- living with a grievous and irremediable medical condition, which means:
- you have a serious and incurable illness, disease or disability (excluding a mental illness until March 17, 2023);
- you're in an advanced state of decline that cannot be reversed; and
- you experience unbearable physical or mental suffering from your illness, disease, disability or state of decline that cannot be relieved under conditions you consider acceptable.
How to start the process
If you're interested in medical assistance in dying, talk with your health-care provider. This can include your family doctor, a specialist or a nurse practitioner. These authorized professionals can discuss the options available to you. They can also refer you to another medical provider who can help.
You can also ask your Community Health Centre nurse for assistance. They can refer you to:
- the next visiting doctor;
- the resident nurse practitioners; or
- a medical professional in Whitehorse.
Compassionate and respectful treatment is at the heart of any assisted dying request.
What is the process?
Submit a written request
You must submit a signed, written request to your doctor or nurse practitioner. If you are unable to write, another adult can sign the request on your behalf under your clear direction. This adult must:
- be at least 18 years of age;
- understand what it means to request medical assistance in dying; and
- not benefit from your death.
This request must also be signed and dated by one independent witness.
If you wish, you can use the Patient request for medical assistance in dying form to make your request.
You can withdraw your request at any time and in any manner.
The independent witness must be at least 18 years of age and understand what it means to request medical assistance in dying.
An independent witness can be a paid professional personal or health care worker.
The witness cannot:
- benefit from your death;
- be an owner or operator of a health care facility where you live or are receiving care; or
- be an unpaid caregiver.
Assessment of your request
After you submit a written request, 2 health professionals will conduct an assessment. They will confirm if you are eligible for medical assistance in dying. Both of these providers need to confirm in writing that you:
- request the service of your own free will;
- are able to make health-care decisions for yourself;
- meet the eligibility criteria;
- have been informed of all care options available to help relieve your suffering, including palliative care; and
- can and do give informed consent.
To be considered independent, neither of the providers:
- can hold a position of authority over the other;
- could knowingly benefit from your death; or
- can be connected to the other, or to you, in a way that could affect their objectivity.
The two providers will determine whether you will soon be approaching the end of your life.
Safeguards for requests where natural death is not reasonably foreseeable
If your natural death is not reasonably foreseeable, there are safeguards in place. They are:
1. 1 of the 2 providers to give an assessment must have expertise in the medical condition that is causing your unbearable suffering.
If neither of these providers do, one with expertise in your medical condition must be consulted in the assessment process.
2. You must be informed of ways to relieve your suffering. This includes:
- counselling services;
- mental health and disability support services;
- community services; and
- palliative care.
You must be offered consultations with professionals who provide those services.
3. You and your providers must discuss ways to relieve your suffering and agree that you have seriously considered them.
4. The assessment period must take a minimum of 90 days. If the providers completing assessments agree that your loss of capacity is imminent, this period can be shorter.
5. Immediately before medical assistance in dying is provided, the provider must allow you a chance to withdraw your request. This ensures that you are giving your consent to receive medical assistance in dying.
If your health provider will not provide assistance
Not every doctor or nurse practitioner will agree to provide medical assistance in dying. If yours will not, they must direct you to another doctor or nurse practitioner who can provide accurate information and guidance.
Informed consent and final consent
You can only give consent after you have received all the information you need to make your decision. This includes:
- your medical diagnosis;
- available forms of treatment; and
- available options to relieve suffering, including palliative care.
You must be able to give informed consent both:
- at the time of your request; and
- immediately before medical assistance in dying is provided unless special circumstances apply.
If you're capable of giving informed consent but unable to sign the request, another person may sign. This will be in your presence and under your direction.
Your alternate or substitute decision maker can't consent to medical assistance in dying on your behalf.
You can withdraw your request at any time and in any manner.
If you are not able to give consent immediately before medical assistance in dying is delivered
Usually, you need to give final consent at the time medical assistance in dying is delivered. You can receive medical assistance in dying without final consent in 2 specific circumstances. They are:
1. If your natural death is reasonably foreseeable and while you have decision-making capacity:
- you were assessed and approved to receive medical assistance in dying;
- your provider advised that you are at risk of losing capacity to provide final consent; and
- you made a written arrangement with your provider to consent in advance to receive medical assistance in dying on a specific date.
2. If you are eligible for medical assistance in dying and you choose to self-administer the medical assistance in dying medications, you may make a written arrangement with your provider so they can administer medical assistance in dying to you if self-administration causes you to lose decision-making capacity but does not cause your death. If you choose this option, the provider must be present at the time of self-administration.
Government of Canada
- Medical assistance in dying legislation
- Medical assistance in dying in Canada
- Guidance for reporting on medical assistance in dying
- Annual report on medical assistance in dying in Canada, 2019
Government of Yukon
- Most responsible medical practitioner record – Patient safeguards and administration for medical assistance in dying
- Secondary assessor record for medical assistance in dying
- Patient request for medical assistance in dying form
- Care Consent Act
- Health Information Privacy and Management Act and Regulations
- Memo on the protocol for completion of a death certificate using medical assistance in dying
- Example of completed registration of death certificate for medical assistance in dying
- Yukon Palliative Care Framework
Talk to your health care provider about medical assistance in dying.