Medical Assistance in Dying Coordinator Now Available

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Medical Assistance in Dying Coordinator Now Available

30-May-2018

Please reach out for more information on end-of-life care

Medical Assistance in Dying is now established as one of the options for end-of-life care. Several physicians in the Regina Area have been involved providing patient assessments and assistance in dying. This is a small proportion of all of the deaths that occur of course. Medical Assistance in Dying should be considered as complementary with palliative care and of course all end of life options should be discussed for consideration in each patient circumstance. Palliative care is offered and provided as is most appropriate.

For some patients even optimal palliative care does not meet their needs or expectations. There are criteria which must be met to ensure that, while patient autonomy is respected, there is never any undue pressure to request assistance in dying or any inappropriate provision of assistance in dying. Conscientious objection by care providers is of course respected but patient needs must also be met. The medication is usually administered by injection which promptly causes loss of consciousness, then soon after death occurs. Obviously making the choice for assistance in dying is a circumstance nobody wants. I have struggled to find the right verb when I meet a patient requesting assistance in dying. I cannot say I am pleased to meet you, as I might say at another patient encounter; I have settled on approaching a new patient saying I am sorry to have to meet the patient and family considering the state of serious and advanced disease, but I am both pleased and honoured that I can offer a choice in difficult circumstances. If, after this, the choice for assistance in dying is made, the death is peaceful and the end of suffering has been appreciated by patients and families.

The criteria include that the patient must be a competent adult, has a medical condition which is, in the words of the Supreme Court, "grievous and irremediable" (which really means that it is bad and there is not a cure that is acceptable to the patient); that there is irreversible decline and that end-of-life is reasonably foreseeable. A patient's usual physician normally offers discussions regarding options as end-of-life approaches and is often the best person for a first assessment for assistance in dying. Two independent assessments are required with a minimum separation of 10 days between patient requests. This ensures that criteria are met and that the request for aid in dying is sustained.

There is now a coordinator for Medical Assistance in Dying who may be reached at 306-766-4551 or by email MAIDReginaArea@saskhealthauthority.ca. Providing access to the informed choice for aid in dying should be part of the continuum of choices for end-of-life care for all of our patients for whom such care is indicated and provided.

Submitted by: Dr. George Carson