Eligibility
What makes an individual eligible for MAiD?
For an individual to receive MAiD, there are a number of eligibility requirements and procedural safeguards in place as defined by federal legislation.
A signed, dated, and witnessed written request must be made. Two independent health care professionals need to evaluate an individual in order to determine whether they meet the eligibility criteria for MAiD. In most provinces this can be either a medical practitioner (family doctor or specialist) or a nurse practitioner; however some provinces currently only allow medical practitioners to be involved.
To qualify for MAiD, a person must satisfy all of the following criteria:
- Be eligible for government-funded health insurance in Canada
- Be 18 years of age or older
- Have a grievous and irremediable condition (see more below about this)
- Have made a voluntary request for MAiD that was not a result of external pressure
- Have decision-making capacity
- Give informed consent to receive MAiD after having received all information needed to make this decision, including a medical diagnosis, available forms of treatment, and options to relieve suffering (including palliative care).
To be considered to have a “grievous and irremediable medical condition,” the individual must have all of the following:
- Have a serious and incurable illness, disease, or disability (note that mental illness as the sole underlying reason for a request for MAiD is not currently allowed but will be as of March 17, 2023)
- Be in an advanced state of decline that cannot be reversed
- Experience unbearable physical or mental suffering from an illness, disease, disability, or state of decline that cannot be relieved under conditions that the person considers acceptable.
Those who have a “reasonable foreseeable natural death”:
For these individuals, MAiD can be performed as soon as the individual is deemed eligible (there is no mandatory waiting period) and they have the option of signing a Waiver of Final Consent if they are at risk of losing capacity before their planned procedure.
Those individuals whose natural death is not reasonably foreseeable:
These people may still be eligible for MAiD, all eligibility criteria are the same, however the procedural safeguards that must be met are different.
There is a minimum 90-day period where eligibility is assessed over time and “to ensure that enough time is devoted to exploring all the relevant aspects of the person’s situation, including whether there are treatments or services that could help reduce the person’s suffering, such as counselling services, mental health and disability support services, community services and palliative care.” (the quote is from the details in Bill C-7).
If neither of the assessors involved have expertise in what is causing the individual’s suffering, a consult to someone who does must be sought to help explore appropriate treatment options.
For additional details visit the federal government’s website.
Upcoming Legislative Changes as of March, 2023
According to the current legislation, if the only reason a person is requesting MAiD is due to a mental health disorder, they are excluded from accessing care. However, this exclusion will automatically ‘sunset’ out of the legislation (i.e. be lifted and no longer in effect) in March 2023.
Whether there will be new rules and safeguards imposed for this population is yet to be determined. More information will be provided as details come available.