MEDICAL ASSISTANCE IN DYING (MAID)
On June 17, 2016, the federal government introduced Bill C-14, which decriminalizes medical assistance in dying (MAID). The College has updated its Code of Ethics, the Health Professions Act bylaws for standards of practice for community, hospital, and residential care pharmacies, and amended the standards, limits and conditions on MAID to reflect the legislation. Bill C-14 addresses physicians, nurse practitioners, pharmacists, and other health care professionals, and exempts them from prosecution under the Criminal Code.
Pharmacists who choose to participate in the MAID process should refer to the following guidelines. Pharmacists are also authorized to delegate preparation duties to a pharmacy technician for the purposes of MAID; however dispensing remains limited to pharmacists.
It is important to note that under the amended Pharmacists Regulation, non-compliance to the Health Professions Act Bylaws Schedule F, Part 5 – Dispensing Drugs for the Purposes of Medical Assistance in Dying is considered a provincial offence.
All MAID deaths will be reported to the BC Coroners Service. The role of the BC Coroners Service will be to ensure compliance with the federal and provincial laws and regulations, and also to gather information about MAID deaths in BC for aggregate reporting purposes.
If a pharmacist chooses to provide pharmacy services in the context of a medical assisted death, the following principles, derived from An Act to amend the Criminal Code and to make related amendments to other Acts (medical assistance in dying), should be adhered to:
The pharmacist is satisfied that the assisted death is being led by a medical practitioner or nurse practitioner;
The pharmacist ensures that he or she does not lead the assisted death process or is seen as leading it, and that he or she does not administer the prescribed drugs to the patient; and
The drugs used for the assisted death are prescribed by the medical practitioner or nurse practitioner and are only dispensed by the pharmacist directly to the medical practitioner or nurse practitioner;
Prior to dispensing the drugs, the pharmacist confirms with the medical practitioner or nurse practitioner leading the process that he or she has made a medical determination that the patient satisfies the criteria for medical assistance in dying set out in section 241.2 of the Criminal Code. The pharmacist should document the confirmation.
British Columbia Medical Assistance in Dying Prescription
A Medical Assistance in Dying British Columbia Pharmacy Protocols guidance document has been developed for Physicians and Nurse Practitioners administering MAID and Pharmacists dispensing medications for MAID. It includes a confidential sample of the Pre-Printed Prescription Order Form that must be used by prescribers of medical assistance in dying. The guidance document is available to registrants through the College’s secure eServices site.
Medical practitioners who are prescribing MAID will access the Pre-printed Prescription Order Form directly from the College of Physicians and Surgeons of BC.
PharmaCare has also published procedures on submitting MAID claims (see Resources below).
All registrants should be aware that it is still a criminal offense to counsel a person to commit suicide. All registrants should ensure that they do not, and cannot be seen to be, advising any person to commit suicide.
For more information on the MAID process, please refer to the resources below.
Links to other MAID Resources