End of Life Decisions: What is Next for MAiD in 2024

You want to know more about end-of-life decisions.

Medical Assistance in Dying (MAiD) was illegal under Canada’s Criminal Code. It was considered homicide or assisted suicide.

In 2014, Quebec introduced an Act respecting end-of-life care.

In 2015, the Supreme Court of Canada in the Carter decision held that the prohibition against MAiD violated the Charter of Rights and gave the federal government time to June 6, 2016 to change the law.

Federal legislation amended the criminal code in 2016 and permitted persons 18 or over to request access to MAiD under certain conditions. There are 2 methods persons can follow:

Method 1 is for a physician or nurse practitioner to administer a substance that causes death; or
Method 2 A prescribed drug is used to self administer MAiD.

In 2019, a Québec court decision held that the requirement for “reasonable foreseeability” of a natural death requirement was also unconstitutional.
The federal government in 2016 created two different tracks for MAiD with different criteria and safeguards. The two tracks are:

1) natural death is reasonably foreseeable (RF); and
2) natural death is not reasonably foreseeable (NRF).

Access to MAiD for mental illness was withheld until March 2023. However, in 2022, the federal government delayed qualifying mental illness as the sole underlying medical condition (MI-SUMC) for MAiD.

On March 17, 2024, persons with MI-SUMC implementation will become eligible for MAiD.

Legislation now permits MAiD for those whose death is not reasonably foreseeable (NRF). To be eligible, applicants must:
• be at least 18 years of age;
• have a grievous, irremediable medical condition; and
• make a voluntary decision without outside pressure in a self request and not through a substitute decision maker.

The test for capacity for MAiD is the test for capacity for treatment decisions under Ontario’s Health Care Consent Act, 1996. Persons must understand information to make treatment decisions and appreciate foreseeable consequences of the decision or lack of a decision.

Clients may ask about planning for end-of-life decisions. Lawyers will need to assist and explain this process as it changes. I have listed some resources below to help you with the terminology. But note, there may be last-minute changes.

Eligibility for MAiD will require:

• Informed consent to receive MAiD;

• Medical assessments – you have independent medical practitioners assess if you qualify by meeting all of the listed eligibility criteria;

• You must sign a written request that you want MAiD; and

• You must be informed of your right to withdraw your request at any time and in any manner.

This trend will require more frank discussions with clients as they discuss powers of attorney for care. Look for more changes and trends in 2024.

Do you have estate planning questions? Contact me today.

Estate law is all I do.