End-of-life considerations

DWDC strives to provide individuals with information about all options available to them so they can make an informed choice based on their wishes and values.

When contemplating end-of-life decisions, you should consult with your health care provider. The content below is for informational purposes only and its content should not be interpreted as medical or legal advice.

Medical Assistance in Dying (MAID)

MAID has been a legal option for those who qualify since 2016. To access MAID, one must be approved by two independent doctors or nurse practitioners and must meet the eligibility criteria found within the law. In Canada, two types of MAID are allowed:

  • A physician or nurse practitioner can directly administer a substance that causes the death of the person who has requested it, and
  • A physician or nurse practitioner can give or prescribe to a patient a substance that they can self-administer to cause their own death.

Additional Resources:

Get The Facts: Canada’s medical assistance in dying law

Health Canada information on MAID

Navigating a Request for MAID

VSED

VSED is an acronym for voluntary stopping of eating and drinking. Competent individuals are legally permitted to refuse oral and artificial nutrition and hydration in all provinces and territories across Canada. VSED is not a process that should be undertaken without medical supervision. It is a very difficult process that requires medication, support and supervision by a practitioner. If this is something you are considering, please discuss with your primary care provider before taking any action. A health care provider will be able to speak to the risks and benefits of all options.

Additional Resources:

Dalhousie University’s Health Law Institute has a comprehensive online document about VSED and VSPeC (Voluntary Stopping Personal Care).

Compassion and Choices, a non-profit organization in the United States, committed to end of life choice, also has a helpful resource on VSED. Please note that this is an American organization so not all information is applicable to those living in Canada.

Switzerland

Switzerland is the only country in the world that permits assisted dying for non-residents. If you are considering an assisted death in Switzerland, it is recommended that you have an assessment by a local nurse practitioner or doctor to see if you are eligible for MAID in Canada first. Over the years, the clinician interpretation of the Canadian assisted dying law has changed and we anticipate further changes to the law, as result of Bill C-7, in the coming months. Please visit our Navigating a Request for MAID page or contact [email protected] if you require assistance finding a local assessor. DWDC is not affiliated with any of the death clinics in Switzerland.

You can read some of the stories of Canadians who have chosen to die in Switzerland here.

Additional Resources:

If you have specific questions about assisted dying in Switzerland, more information including contact information, can be found on these websites:

Dignitas

Life Circle

Pegasos

Do-Not-Resuscitate orders

One way a person can refuse life-saving treatment is through what is known as a Do-Not-Resuscitate order, or a DNR. By filling out a DNR order, a person is communicating that they do not want to receive emergency life-saving measures, such as cardiopulmonary resuscitation (CPR), in the event that they become critically ill or suffer a catastrophic injury.

Most provinces and territories have their own DNR forms for residents to use. However, the names of these forms, and the range of situations in which they can be enforced, may differ from one jurisdiction to the next.

Because a DNR order is usually written on a government-issued form, people expect that their wishes will be understood and respected. Unfortunately, this isn’t always the case. Paramedics or firefighters responding to a 911 call don’t have time to search a person’s residence for a DNR form. In addition, according to a 2017 CBC News investigation, almost none of Canada’s provinces and territories have a central electronic database tracking residents’ DNR orders. As a result, many people receive invasive, often painful, life-saving interventions despite having refused those options via a DNR order.

Palliative Care

Palliative care focuses on both pain management and optimizing quality of life. A person does not need to be dying or in the final stages of an illness to benefit from palliative care. A palliative care approach can work to alleviate physical symptoms and discomfort, and is also beneficial when considering emotional distress or spiritual needs for both the patient and those close to them.  
Palliative care and medical assistance in dying (MAID) are not mutually exclusive. A person pursuing MAID can also have palliative care and vice versa.

Additional Resources:

For more information on palliative care as well as a directory of local supports, we recommend the following organizations and resources:

Tel: 613-241-3663
Toll Free: 1-800-668-2785

Tel: 1-833-888-5327

Email: [email protected]