1. Medical Assistance in Dying M.A.I.D.
Marilyn Gladu Jan 2019

2. Topics History in Canada- the Carter Decision C-14 Palliative Care
Consultations on Advanced Consent, Minors and those suffering mental disorders
History Elsewhere- Its not that simple

3. History in Canada 50 years of discussion The Carter decision 2015 C14
Palliative Care Bill C277
Outcomes ( Sarnia 2, London 300, nationally ~ 4000)

4. Advanced Consent- 3 issues
How to prove it is informed consent
The third party responsible to enforce the decision- what if there is disagreement
Who decides what is intolerable suffering when the person has lost capacity
Belgium and Luxembourg only allow when a person is permanently unconscious

5. Mature Minors No definition nationally 14-17 in Quebec
For informed consent, need capacity to make a medical decision, to be provided information in a way that facilitates understanding, and to make a voluntary choice free from duress or coercion
Netherlands allows with parental permission, parental consultation
Belgium must be terminal, and must provide pediatric palliative care as option

6. Mental disorders – Very Controversial
Working group on study could not agree
Capability for informed consent
Concern for MAID where death is not reasonably foreseeable that you could get better and change your mind
How to differentiate those that want to commit suicide as a symptom of their mental disorder
Netherlands allows for dementia, but with much controversy

7. Palliative Care
Where quality palliative care exists, 95 % of people choose to live as well as they can for as long as they can
Palliative Care Framework
World Health Organization Definition
Difference from M.A.I.D.