What are the criteria for Medical Assistance in Dying (MAID) eligibility in British Columbia?

Medical Assistance in Dying (MAiD) Eligibility Criteria in British Columbia

In British Columbia, to be eligible for Medical Assistance in Dying (MAiD), a person must have intolerable physical or psychological suffering that cannot be relieved in a manner they consider acceptable, and have a serious and incurable illness, disease, or disability. 1

Core Eligibility Requirements

• The patient must have intolerable physical or psychological suffering that cannot be relieved in a manner they consider acceptable 1
• The patient must have a serious and incurable illness, disease, or disability (not solely psychiatric) 1
• Unlike some jurisdictions, Canada (including BC) does not have a life expectancy requirement for MAiD eligibility 1

Patient Qualifications

• The patient must be a competent adult capable of providing informed consent 2
• The patient must make a voluntary request without external pressure 2
• The patient must be able to make informed decisions about their health 2, 3
• The patient must be eligible for Canadian health services 2

Assessment Process

• Two independent healthcare practitioners must assess the patient's eligibility 2
• The patient must be informed of all available treatment options including palliative care 4
• The patient must understand their medical diagnosis, prognosis, and available treatments 4
• There must be a reflection period between the request and provision of MAiD 2

Understanding Suffering in MAiD Context

• Suffering is assessed based primarily on the patient's self-report 4
• Suffering is understood as multidimensional, including physical, psychological, existential, and social components 4
• The assessment should explore what led the patient to inquire about MAiD to better understand their concerns 5
• The evaluation of unbearable suffering can be challenging as it is often psychological, existential, and social in nature 4

Incurability Requirement

• The incurability requirement cannot be understood solely as a feature of a person's medical condition but involves the interplay between the nature of the pathology and the person's treatment decision-making 3
• A condition may be considered incurable when available treatments cannot sufficiently improve the condition or when treatments carry unacceptable side effects or burdens from the patient's perspective 3

Common Reasons for MAiD Requests

• Loss of autonomy 5
• Loss of ability to participate in activities that make life enjoyable 5
• Loss of dignity 5

Important Considerations and Caveats

• Healthcare providers have the right to conscientiously object to participating in MAiD 2
• Referral to local MAiD resource centers should be considered if further discussions are required 1
• Faith-based institutions may refuse to provide information about MAiD to patients or allow assessments or deaths to occur on site 2
• The patient's capacity for providing consent may change over time, requiring ongoing assessment 1
• Providers should be aware of relevant provincial legislation related to determining capacity 1

Provider Responsibilities

• Each member of the healthcare team should understand their roles and responsibilities as defined by their respective provincial college or professional organization regarding discussions about MAiD 1
• Healthcare providers should respond to inquiries about MAiD in a compassionate, patient-centered manner 5
• Providers should be familiar with the legal status of MAiD in their jurisdiction 5

By understanding these criteria and following the established protocols, healthcare providers can ensure that patients who qualify for MAiD in British Columbia receive appropriate care while maintaining ethical standards and legal compliance.