We've put together a list of frequently asked questions. Don't see the information you're looking for? Feel free to contact us.
Yes. You must successfully complete additional education before aiding in the provision of MAiD. Additional education is structured education (e.g. workshop, course, program of study) that builds on your entry-level competencies.
Additional education includes both theory, practice application and evaluation of your competencies on completion. Additional education is usually offered by employers and does not need to be approved by BCCNM. For more information, see the scope of practice standards, limits and conditions specific to MAiD relevant to your nursing designation.
If you are an NP who is assessing eligibility or providing MAiD, you must meet
additional education requirements.
Yes. A decision support tool supports standardized, consistent and safe client care. DSTs clarify your roles and responsibilities related to the procedure and outline the expectations of your organization. DSTs are created or approved by employers, not by BCCNM.
No. If you have a conscientious objection (moral or religious beliefs and values that differ from those of a client) to MAiD, you must take all reasonable steps to ensure that the quality and continuity of care for your client is not compromised. Notify your organization well before your client is to receive MAiD. You are required to ensure a safe transfer of care to an alternate provider that is continuous, respectful and addresses the unique needs of your client. The Duty to Provide Care Practice Standard will provide you with additional direction about your responsibilities.
There is an important difference between the intended outcomes of MAiD and palliative care. MAiD supports a person who requests assistance in dying to end their life in a respectful, culturally appropriate, safe, ethical and competent manner.
Palliative care supports a person's quality of life when they are going through a life-limiting illness. The intended outcomes of palliative care include reducing intractable pain and suffering at the end of life.
You have an important role in providing high quality client-centered end of life care, which includes activities such as advocating for clients, providing information, participating in decision-making, caring for and supporting clients and their families and collaborating with members of the health care team to ensure that clients have their care and information needs met.
The Criminal Code permits health care professionals to provide information about MAiD to a client. Nurses can provide information, engage in discussions, and educate their clients about MAiD.
However, counseling a person to commit suicide is still a criminal offence. For the purposes of the Criminal Code, "counsel" means encourage, solicit or incite. Due to the criminal significance of the word "counsel," be mindful in your work with clients not to encourage, counsel, advise, recommend or in any way seek to influence a client to end their life.
You may choose to refer a client's inquiries about MAiD to their physician/NP, to a designated MAiD health care team, or to the organization's staff who may be in a better position to answer questions about services available at the organization. Every B.C. health authority has a designated person to help connect persons requesting information on MAiD with a physician or NP who can provide guidance. For people living or care providers working in First Nations communities, you can email the First Nations Health Authority (firstname.lastname@example.org).
Use your professional judgement, employer policies, and the BCCNM Documentation practice standard to document your nursing activities. The NP or physician providing the assisted death will document their own assessments and care including the administration of MAiD medications on the provincial MAR for MAiD.
RNs can aid an NP or physician to provide MAiD by inserting an IV or PICC line that will be used to administer MAiD medications. LPNs and RPNs are limited to starting an IV only (not PICC lines).
If a nurse is asked to start an IV line to aid a physician/NP's administration of MAiD medications, they may be considered to be aiding in the provision of MAiD. Make the necessary inquiries to satisfy yourself that the client has met the legal requirements for MAiD.
If the IV team is called to start an IV for administering MAiD, tell the client that the IV team will need to be told the purpose of the IV. Assure the client that this information will be disclosed only to those who are involved in their care. Be aware of and follow any organizational policies related to client privacy.
As well, inform the IV team about the purpose for the IV. It's possible the IV nurse may have a
conscientious objection based on their basic values and beliefs. Providing information to the IV team in advance may prevent a potential conflict for the nurse or a delay in starting the IV.
Recognize that there is a difference between starting an IV for the sole purpose of MAiD versus for the purpose of the client's normal course of treatment. Starting an IV or PICC line is general nursing care if not directly related to the provision of MAiD.
While it's ethically appropriate that you're not the one to give the information, it's not ethically appropriate to prevent your client from receiving information about, or to influence their decision to pursue MAiD.
When a client requests information about MAiD, respond in an empathic, professional and non-judgmental way. Listen carefully to what is being said (and what is not said), and check that you have understood the client's concern accurately. Clarify your understanding, as clients sometimes talk about death in ways that can be confusing - some clients express that they wish to die or 'are ready' to die. Acknowledge the client's feelings and concerns regarding their illness, and gently probe for more details about their perceptions of their illness, prognosis, and death and dying. This may help to uncover unmet needs or fears.
If the client is asking about MAiD, it should prompt a discussion to find out the reasons for the request. Acknowledge the information request and resist the inclination to 'ignore' the request or end the conversation. Involve other team members as appropriate so the client is aware of available end of life options and care. An example of a response that you could provide when you are asked for information about MAiD: "I'm not able to answer some of your questions. Let me find someone who can help to make sure you are aware of all the end of life options and care."
There is a difference between caring for a client as a person and having a conflict based on your basic values and beliefs with a client's request for a particular treatment or procedure. You are not required to assist in the provision of MAiD; however, you have a professional and legal obligation to provide your clients with safe, competent and ethical care. Don't allow your personal judgments about a client who has requested a medically assisted death to compromise the client's care by withdrawing or refusing to provide general nursing care.
If the client rings their bell, it's important to answer it promptly to find out what they need. Assistance with personal hygiene, toileting, or a request for fluids or food are general nursing care activities nurses provide to clients. You will need to ensure that these needs are met.
Like other situations involving conscientious objection, the nurse has the right to refuse to participate in the procedure. However, the nurse does not have the right to refuse to provide general nursing care to the client. The nurse is required to let the supervisor and other team members, as appropriate, know about their conscientious objection.
While the federal legislation does not force any nurse to participate in the MAiD procedure, the nurse does not have the right to refuse the client general nursing care. Post-mortem care is a general nursing care activity that you may need to provide, if requested to do so.