MAiD in Canada

Definition: MAiD (Medical Assistance in Dying) involves assistance provided by a doctor or nurse practitioner to intentionally cause a person’s death at their request.
Two methods:
- Administered by a physician: A doctor or nurse practitioner directly provides a drug that leads to the patient's death.
- Self-administered: A doctor or nurse practitioner prescribes a drug that the patient can take themselves to cause their own death.

Key Cases:
- Ciarlariello v. Schacter (1993)
- Rodriguez v. British Columbia (1993)
- Oakes Test (1986): A framework for analyzing the constitutionality of laws that restrict rights, which includes four criteria:
  - The restriction must be pressing and substantial.
  - The restriction must be rationally connected to its purpose.
  - It must minimally impair the violated Charter right.
  - The benefits must outweigh the costs (proportionality).
- R v. Latimer (1997): Significant case in the context of assisted dying.
- Quebec National Assembly, 2014: Involved discussions and legislative movements regarding MAiD.

Context:
- Stemming from Carter v. Canada (2015), which found that prohibiting assisted suicide for consenting adults violated their rights to life, liberty, and security.
Provisions of Bill C-14:
- Allows assisted death for a competent adult who:
  - Clearly consents to life termination.
  - Has a grievous and irremediable medical condition causing intolerable suffering.

Must be at least 18 years old and mentally competent.
Must have a grievous and irremediable medical condition.
Voluntary request free from external pressure.
Must provide informed consent for MAiD.
Must experience unbearable suffering from an illness or state of decline.
Natural death must be reasonably foreseeable but does not require a specific prognosis.
Must be eligible for government-funded health services.

Reported suffering types:
- Emotional distress, anxiety, fear, existential suffering: 82.1%
- Loss of ability to engage in meaningful life activities: 78.1%
- Loss of dignity: 53.3%
- Feelings of being a burden to family: 34.0%
- Loss of control of bodily functions: 31.9%
- Isolation or loneliness: 13.7%

Changes from Bill C-14: No longer requires natural death to be reasonably foreseeable.
Updated eligibility:
- Must be 18 years or older and have decision-making capacity.
- Eligible for publicly funded health care services.
- Must provide a voluntary request free from external pressure.
- Suffering from a serious incurable illness, excluding mental illness until March 17, 2023.
- In an advanced state of irreversible decline.
- Enduring and intolerable suffering that cannot be alleviated in acceptable conditions.

Data Overview:
- 2016-2021 breakdown of MAiD deaths per province/jurisdiction in Canada.
- Overall total: 31,664 MAiD deaths recorded across Canada during this time period.

Global perspectives as of Aug 31, 2022:
- Legal frameworks differ regarding the prescription and administration of medical assistance in dying.
- Some areas are moving towards legalization, particularly in Australia.

Key Themes Discussed:
- Issues of accessibility and patient choice.
- Concerns about equity in access to MAiD.
- The evolving understanding and criteria for eligibility.
- Emotional stress associated with ineligibility and potential for pressure to change eligibility.

Reporting: Concerns have been raised about the potential for individuals to choose MAiD due to financial pressures, highlighting socio-economic dimensions affecting choices related to assisted death.