Medical Assistance in Dying

What is medical assistance in dying (MAiD)?

MAiD means the administration by a medical practitioner or a nurse practitioner of a substance or drug to a person, at his or her request, that causes his or her death.

In June 2016, amendments to Canada’s Criminal Code permit medical practitioners and nurse practitioners to provide MAiD. They also permit pharmacists and other persons, including LPNs, to assist in the process. Federal and provincial legislation contain safeguards to make sure MAiD is carried out appropriately and protects people from abuse or misuse.

Who can participate in MAiD?

In BC, physicians and nurse practitioners can provide MAiD and others can assist in providing the service, including:

  • pharmacists,
  • health care providers who help physicians, e.g., LPNs, and
  • family members or other people that are asked to help.

Who is eligible for MAiD?

Anyone requesting MAiD must meet all of the following conditions:

  • Be eligible for health services funded by the Canadian government, or a province or territory 
  • Be at least 18 years old and mentally competent 
  • Have a grievous and irremediable medical condition
  • Make a request for medical assistance in dying which is not the result of outside pressure or influence
  • Give informed consent to receive medical assistance in dying after being given all of the information needed to make the decision, including information about:
    • his or her medical diagnosis
    • available forms of treatment
    • available options to relieve suffering, including palliative care

What is a grievous and irremediable medical condition?

To be considered as having a grievous and irremediable medical condition, a person must meet all of the following conditions. He or she must:
  • Have a serious illness, disease or disability
  • Be in an advanced state of decline that cannot be reversed
  • Be suffering unbearably from the illness, disease, disability or state of decline
  • Be at a point where natural death has become reasonably foreseeable, which takes into account all of the person’s medical circumstances

The person does not need to have a fatal or terminal condition to be eligible for MAiD.

What is the LPN’s role?

LPNs are self-regulating professionals who are accountable for providing safe, competent and ethical care within the legal framework of nursing regulation. CLPNBC’s Standards of Practice and employer policy lay out the requirements for LPN practice in all practice settings including end-of-life and palliative care. The LPN’s role is limited to assisting medical practitioners who are providing MAiD. For example, LPNs may:

  • Carry out nursing assessments
  • Make a nursing diagnosis
  • Discuss end of life options with clients
  • Create and implement nursing care plans
  • Provide nursing care to clients who are dying and support to their families
  • Collaborate, consult with and refer to other members of the health care team 
  • Advocate for clients

LPNs do not administer any medication intended to cause the client’s death. LPNs may insert the IV line that the medical practitioner will use to administer the medication and they may be present during the administration of the medication to provide nursing care to the client and family.

Can an LPN witness a client’s request for MAiD? 

LPNs may witness a consent for MAID if they are not directly involved in providing health services or personal care to the client and will not benefit from the client’s death.

What if an LPN’s beliefs or values conflict with MAiD?

LPNs who have a conscientious objection may ask their employer, in advance, to exempt them from participating in MAiD. See CLPNBC practice standard Duty to Provide Care

What is the employer’s role?

Employers are developing policies and resources for LPNs and other staff who may become involved in MAiD. These policies and resources will evolve and change over time as Canadians have more experience with MAiD.

How is MAiD different from palliative care?

While MAiD helps people end their lives, palliative care aims to improve the quality of life for people living with a life-threatening condition. Different people will make different choices about the end of their lives. 

Next steps

CLPNBC is collaborating with the Ministry of Health, employers, regulators and others to develop standards and resources for LPNs who may become involved in MAiD.

Other Resources

College of Physicians and Surgeons of BC, Medical Assistance in Dying

College of Registered Nurses of BC, Medical Assistance in Dying

Government of BC, Medical Assistance in Dying 

Government of Canada, Medical Assistance in Dying

If you have further questions or concerns: