Provincial guidelines for medical assistance in dying

As everyone knows, lawmakers in Canada have been dealing with how to put together legislation that allows for medical assistance in dying (MAID). CBC News has reported that all provinces and one of the territories have put their guidelines in place. A summary of the requirements, broken down by each province, can be found here.

Though there are differences from region to region, there are also some consistencies. One consistency is that requests for MAID cannot be made in advance. This would rule out the possibility of including such a request in a health care directive, as such documents are made in advance in anticipation of a day in which a patient can no longer make decisions.

The guidelines contemplate a specific situation in which a patient is "suffering from a serious and incurable illness, in an advanced state of irreversible decline and experiencing constant and unbearable physical or psychological suffering which can't be relieved in a manner acceptable to the patient". This ties in with the requirement for the patient to have mental capacity to make the request for MAID. Given that an advance health care directive is used only when a patient does not have mental capacity to make decisions, the requirement for mental competency rules out the use of an advance health care directive.

Time will tell how these guidelines work out.