Medical Assistance in Dying

As of June 17, 2016 the Criminal Code has been changed by federal legislation extending the exemption from the criminal code to nurses, pharmacists and other staff aiding a physician in assessment and provision of medical assistance in dying.  The Request and Assessment forms for use in all cases (see below) have been updated with the confirmed eligibility criteria.

Staff contacted by patients for information are advised to provide the information pamphlet at this link.

To:

Staff with questions or comments – or who are seeking a physician or nurse practitioner to assist a patient with exploring a request for medical assistance in dying – are invited to please contact the Assisted Dying Program at assisteddying@vch.ca or 604-613-5885.  Learn more about the Care Coordination Service of the Assisted Dying Program at this link.

 

Background:

On February 6, 2015, the Supreme Court of Canada (SCC) in Carter v. Canada struck down the provisions in the Criminal Code prohibiting medical assistance in dying (sections 241(b) and section 14), effective February 6, 2016.

As of June 17, 2016 the Criminal Code has been changed by federal legislation clarifying criteria for eligibility and other safeguards concerning medical assistance in dying, confirmation of the exemption from Criminal Code exposure for nurses, pharmacists and other staff aiding a physician in assessment and provision of medical assistance in dying, and commitment of Government to monitor and learn from experience over time.

Medical assistance in dying – VCH Policy

See the policy here, setting out the expectation to sensitively address requests, and to respect the conscience rights of colleagues who do not wish to participate in assessment for or provision of medical assistance in dying.

Forms

The forms below have been developed for use in all cases across BC, those in community, in facility settings, and those across both settings.

Medical Assistance in Dying – Record of Patient Request

Medical Assistance in Dying – Assessment Record (Assessor)

Medical Assistance in Dying – Assessment Record (Assessor/Prescriber)

Medical Assistance in Dying – Consultant Assessment of Patient’s Informed Consent Decision Capability

BC Coroners Service Report of Medical Assistance in Dying Death

Documentation Submission Checklist.

Medical assistance in dying – Information for practitioners

Your comments and feedback are invited on the following documents.  Please submit questions or suggestions for improvement for these documents, or suggestions for other documents that would be helpful to assisteddying@vch.ca

Interdisciplinary process guidance

Comments and suggestions are welcome on this document intended to provide guidance on the steps and interactions of providers supporting patients in their requests for medical assistance in dying.  See the document at this link.

VCH Guidance for staff approached by patients, residents, and clients seeking assistance and advice

Staff may be approached by patients, residents, and clients with questions about medical assistance in dying.  VCH staff members are encouraged to review the guidance at this link to deal sensitively with the question.

Ministry of Health resources for providers

Providers can access current guidance from the Ministry of Health on fees, some forms, and access to medications at this link.

Information for patients

To provide basic information for patients, please print this Fact Sheet (English, also available in Traditional Chinese) document or Brochure. Additional copies are  available from Patient Health Education Materials.

Information for managers

Managers have a critical role in preparing their teams for potential requests, and supporting their teams in supporting patients when a request is made.  This summary provides some additional background.

Links to Educational Resources

Medical Assistance in Dying (MAiD) for Registered Nurses:

This course meets the CRNBC requirement for additional education for nurses if inserting an IV for purpose of Medical Assistance in Dying.  Staff are welcome to take the course even if they are not acting in an IV Support RN role.

Accessing Medical Assistance in Dying (MAiD) for Registered Nurses:

Please go to https://learninghub.phsa.ca and create an account if you have not already created one.

The direct link to the course is – https://learninghub.phsa.ca/Courses/7729

Medical Assistance in Dying (MAiD) for Assessors and Prescribers:

Four modules intended to provide a foundation for physicians and nurse practitioners serving as Assessors or Assesor / Prescribers.  A Certificate of Completion will be provided to those participants achieving 80% or higher on the quiz.

Accessing Medical Assistance in Dying (MAiD) for Assessors and Prescribers:

Please go to https://learninghub.phsa.ca and create an account if you do not have an account.

The direct link to the course is – https://learninghub.phsa.ca/Courses/8111

Medical Assistance in Dying: A thoughtful and respectful approach, October 19, 2016 (1 hour)

An overview and videorecording of the Vancouver All-Staff forum; general overview, panel discussion, and Q&A

Collaboration and Compassion: a team approach to medical assistance in dying, September 28th, 2016 (4.5 hours in total)

Individual segments of the VCH and PHSA education session on medical assistance in dying; overview, detailed discussion on roles of physicians, nurses, pharmacists, and Q&A

  1. If necessary, create a user account  at https://learninghub.phsa.ca (“Sign Up for an Account”)
  2. Login and search ‘medical assistance in dying’, or
  3. Access the course directly at this link

Federal Legislation 

The federal government has introduced legislation to establish a more detailed framework for medical assistance in dying.  Read more about it at this link.

Becoming a Prescriber

Physicians and Nurse Practitioners may serve as Assessors within their usual practice.  To serve as an Assessor / Prescriber, that is to order and administer medication to provide medical assistance in dying, providers must seek and be granted a non-core privilege.   The document as this link describes the application process.  For discussion contact the Assisted Dying Program at assisteddying@vch.ca, 604-875-4240

And replace the document at ‘this link’ with the attached (Application 7 3 17)

British Columbia Pharmacy Protocols

For BC Pharmacy Protocols for Medical Assistance in Dying and discussion with Pharmacy about the BC Medical Assistance in Dying Prescription form, please contact the Clinical Coordinator in the pharmacy supporting your usual practice setting.

Guidance

College of Physicians and Surgeons of British Columbia

Please see here for the most current guidance from the College of Physicians and Surgeons of British Columbia, last updated on June 23, 2016, in addition to their FAQ.  Please check the College website to confirm there is no more current advice.

College of Registered Nurses of British Columbia

Please see here for the most current guidance from the College of Registered Nurses of British Columbia, last downloaded on June 6, 2016 at 0900.  Please check the College website to confirm there is no more current advice.

College of Pharmacists of British Columbia

Please see here for the most current guidance from the College of Pharmacists of British Columbia, last downloaded on June 6, 2016 at 0900.  Please check the College website to confirm there is no more current advice.

 

Information accessible by the public can be found on the Vancouver Coastal Health Website.