Offering support to a loved one requesting medical assistance in dying

In Canada, people suffering from a grievous and irremediable illness or physical disability and whose condition is deteriorating have the right to request medical assistance in dying (MAID). Is your loved one in this situation? Have they shared their wishes with you?

Despite the initial shock, you will surely want to offer this person your support. Let’s take a look at your role in all of this.

Your role: Providing support

Your loved one’s decision to request MAID is theirs and theirs alone. Family members do not have the right to refuse such a request.

Your role is therefore to support this person by being present, respectful, understanding and caring throughout the entire process. Such support can be given for both procedural tasks (paperwork, forms, appointments, preparations, etc.) and on an emotional level.

Here are some actions and attitudes that can help you better support your loved one during their last moments:

• Refrain from judgment; respect their wishes.
• Don’t hesitate to ask them what you can do to help.
• Respect their limits.
• Help them submit their request, go along with them to their appointments or help them fill out the forms (if they want you to).
• Be there for them and listen.
• Help care for them while ensuring their comfort in the time leading up to the procedure and during the procedure.
• Do not forget about your own well-being. Make sure you have support from a loved one.

It’s normal to feel worried, sad, angry and disconcerted. Take the time needed to experience these emotions in order to come to terms with them. Never hesitate to reach out for help during this difficult time. To be able to take care of your loved one, you must take care of yourself.

Learn more about MAID

An important step toward understanding your loved one’s decision and helping them is learning about MAID.

There are many resources available. For example, you can download this introductory pamphlet to become more familiar with the procedure.

MAID eligibility requirements 

MAID has been legal in Canada since 2016. People suffering from severe illness are thus able to die with dignity, when they choose. That said, it remains a closely regulated and monitored procedure.

If your loved one is ill and wishes to put an end to their suffering by requesting MAID, they must first meet a series of strict eligibility criteria.

They must:

• Be eligible for provincial health services.
• Be at least 18 years old.
• Be mentally capable of making informed health-related decisions.
• Have a grievous and irremediable medical condition (the condition must affect the person’s quality of life, be in an advanced state of decline, and cause physical or psychological suffering).
• Make a voluntary request for MAID.
• Give informed consent to receive MAID.

Consent to receive MAID cannot be given in advance through power of attorney or any other means. The person must be able to make an informed decision. As such, people suffering from a neurocognitive illness such as Alzheimer’s are currently not eligible to receive MAID if their state of consciousness does not allow them to give their consent.

However, a legislative bill that would allow such people to make an advanced request is expected.

Supporting a loved one through the steps to receive MAID

To receive MAID, your loved one will have to follow a series of steps. You can accompany them through these steps if they wish to have your support.

It’s a highly emotional experience both for you and your loved one. Remember that your loved one wishes to have a say in how they will live their last moments. This is often why people choose MAID.

Your role is to provide a caring presence with respect and understanding.

Here are the main steps involved.

1. Submit an official MAID request to the treating physician

Your loved one must first tell their doctor (verbally) that they wish to receive MAID. It must be a formal request.

2. Complete the form

Once the verbal request is made, they must complete the MAID form they will receive.

This form will validate the person’s eligibility.

3. Signatures

Once completed, the form must be signed in the presence of a health professional, who must also sign the form.

The form must also be signed by an independent, unbiased witness (such witness cannot be an heir of the person requesting MAID and cannot benefit from their death).

4. Assessment

Once the form is completed and signed, your loved one will undergo an assessment performed by two physicians. For the request to be accepted, both physicians must confirm that your loved one is eligible for MAID.

5. Preparations

Once the request is accepted, your loved one will meet a different physician whose responsibility is to ensure that they still wish to receive MAID. This physician will also verify that the person still meets the eligibility requirements.

At this point, the date and location of the procedure can be determined. Your loved one can then state the people they wish to have in attendance for the procedure and any rituals they wish to observe.

You can accompany your loved one during these preparations by offering them your support, a listening ear and your presence.

Your support during the MAID procedure

The decision to be present or not during the MAID procedure is entirely up to you.

There are three steps involved:

1. Administration of anti-anxiety medication to put your loved one into a light sleep.
2. Administration of a second medication to induce deep sleep.
3. Finally, a third medication is administered to slow down and stop breathing.

Throughout the procedure you will be able to sit beside your loved one, hold their hand, speak to them and touch them. You are free to step out of the room at any time.

You can stay in the room a few hours following their death. Upon leaving, you must bring your loved one’s personal belongings. The medical team will provide you with resources as you may require support of your own at this time. Don’t be afraid to ask a loved one to come and pick you up.

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