What are the eligibility criteria?
The law has established highly restrictive conditions that a person must meet in order to receive medical assistance in dying (MAID). Several procedures must also be followed by physicians and health facilities.
Requirements for MAID applicants
Be eligible for health services funded by a federal, provincial or territorial government in Canada (or during the applicable minimum period of residence or waiting period for eligibility).
- Generally, visitors to Canada are not eligible for medical assistance in dying.
Be at least 18 years old and mentally competent. This means being capable of making healthcare decisions for oneself.
Have a grievous and irremediable medical condition that is causing physical or psychological suffering that a person deems to be intolerable.
Make a voluntary request for medical assistance in dying that is not the result of outside pressure or influence.
Give informed consent to receive medical assistance in dying.
Make sure that the patient is making the request freely and not as a result of external pressure.
Make sure that the request is an informed one, in particular by informing the patient of the prognosis for the illness and of other therapeutic possibilities and their consequences.
Verify the persistence of suffering and that the repeatedly expressed wish to obtain MAID remains unchanged by talking with the patient at different times. These discussions must be held at reasonably spaced intervals given the progress of the patient’s condition.
Discuss the patient’s request with any members of the care team who are in regular contact with the patient; this may include the applicant’s attending physician.
Discuss the patient’s request with his or her loved ones, if the patient so wishes.
The second doctor must also be independent of the person who made the request for medical aid in dying.
What does it mean to have a grievous and irremediable medical condition?
Have a serious illness, condition or disability (excluding mental illness, an exclusion that will need to be revised by March 17, 2023).
Be in an advanced state of decline that cannot be reversed.
Experience unbearable physical, mental or existential suffering from an illness, disease, disability or state of decline that cannot be relieved under conditions that they consider to be acceptable.
What does it mean to give informed consent?
To be eligible, the patient must provide informed consent to the practitioner who will assess their eligibility.
A medical diagnosis
Available forms of treatment
Available options to relieve suffering.
The patient must be able to give informed consent at the time of their request. If a person’s health status places them in Group 1, “patients with a reasonably foreseeable natural death,” final consent—at the time of treatment—will not be necessary if the “Waiver of Final Consent” has been signed (See: Waiver of Final Consent).
If a person falls under the category “natural death is not reasonably foreseeable,” final consent will be required immediately before MAID is provided.
The patient has the right to withdraw consent at any time and in any manner.
About mental illness and MAID
- If a person has a mental disorder and this is their sole medical condition, they are not eligible to seek medical assistance in dying. Under new changes in the law (Criminal Code, section 241, amended in March of 2021), Canadians who fall into this category do not have the right to apply for MAID. This exclusion will remain in effect until March 17, 2023.
- This temporary exclusion provides more time for the Government of Canada to consider how MAID can be provided safely to those whose sole medical condition is a mental disorder.
To support this work, the government will initiate an expert review to consider protocols, guidance and safeguards for those with a mental disorder who are seeking MAID, and will make recommendations by March 17, 2023.
If a person has a mental illness as well as another grievous and irremediable physical illness, disease, or disability, they may be eligible for medical assistance in dying, provided that they meet all of the eligibility criteria. In other words, if a person has a physical condition that makes them eligible for MAID, they can receive it if they meet the usual criteria, even if they have a mental disorder, as long as they still have decision-making capacity, which is the case for most people with mental health issues. Eligibility is assessed on a case-by-case basis, considering all relevant circumstances. However, patients must meet all criteria to be eligible for medical assistance in dying.