Medical Assistance in Death (MAID) and the Personal Care Directive (PCD)

When the legislation legalizing medical assistance in death first came out, many people asked if their wishes to use medical assistance in death in certain medical situations could be included in their Personal Care Directive.  Unfortunately the answer, at this point in time, is no. Your Personal Care Directive cannot include any direction regarding medical assisted death.  This may change in the future as the current legislation is always subject to review and change.

The main issue preventing a direction regarding medically assisted death in your personal care directive is competency.  In order to be eligible for MAID, you must meet all of the following requirements:

1.       Be 18 years of age and mentally competent;

2.       Suffer from a grievous and irremediable medical condition;

3.       Make a voluntary request for MAID;

4.       Be able to give informed consent; and

5.       Be eligible to receive health services in Canada

A PCD only becomes active when the donor is declared mentally incompetent and unable to make their own medical and personal decisions.  Once that has occurred the person appointed as their Agent in the PCD is responsible for making all personal and medical decisions on their behalf.  If a request for MAID is to occur at this stage, the patient would be denied as they are no longer eligible as they do not meet the requirement of informed consent.

Even if the request is contained in the PCD and the Agent is requesting it, the request is still invalid because the request must be made voluntarily.  This means that it must come from the patient with no outside influences.  A mentally incompetent patient cannot assure MAID assessors that it is their voluntary wish to die or that they have not changed their mind, especially if the PCD was drafted and signed years earlier.

Currently, part of the procedures for MAID require that once a patient is approved, they must wait a mandatory 10 day period in which they can change their mind about proceeding with procedure.  There are instances in which people who are approved for MAID have decided to extend the time between approval and the procedure in order to be alive for major life events such as a marriage or birth.

Unfortunately, under the current legislation, MAID cannot be instituted or requested through a PCD.  This may change in the future.  Legislators, as well as medical and legal professionals are still looking at the relationship between MAID and PCDs.  This may lead to a process in which PCDs can play a part in MAID.

For more information about Alberta Health Service’s MAID process, please visit www.ahs.ca/MAID

If you are interested in getting a Personal Care Directive or other estate planning documents, please contact us for assistance.