Frequently asked questions

Q: What was the Supreme Court Decision made on February 6th 2015

A: On February 6th 2015, The Supreme Court of Canada declared:

“The prohibition of physician assisted dying infringes the right to life, liberty and security of the person in a manner that is not in accordance with the principles of fundamental justice”

They concluded that the prohibition on physician assisted dying is void insofar as it deprives a competent adult of such assistance where:

  1. The person affected clearly consents to the termination of life and
  2. The person has a grievous and irremediable medical condition (including an illness, disease, or disability) that causes enduring suffering that is intolerable to the individual in the circumstances of his or her condition.

Q: Are there any other places that have similar legislation?

A: Yes. Physician assisted dying has been legal in the following jurisdictions:

  1. In Oregon since 1997, The Death with Dignity Act (the Act) allows terminally ill Oregonians to end their lives through the voluntary self-administration of lethal medications, expressly prescribed by a physician for that purpose.
  2. On November 4, 2008, the State of Washington passed Initiative 1000, the state’s Death with Dignity Act, which became law on March 5, 2009. Information about the Washington Death with Dignity Act can be found athttp://www.doh.wa.gov/dwda.
  3. In 2009, the Montana Supreme Court ruled that physicians may assist patients in ending their lives by prescribing lethal medications (to be self-administered by the patient), citing the state’s Rights of the Terminally Ill Act. Information on the Montana Supreme Court decision can be found at http://searchcourts.mt.gov/getDocument?vid={88A87FE0-2501-438A-AC31-CCE62D37C894}.
  4. In 2013, the Vermont General Assembly passed Act 39, the state’s Patient Choice and Control at End of Life Act, which was signed into law on May 20, 2013. Information about the Vermont Patient Choice and Control at End of Life Act can be found at http://healthvermont.gov/family/end_of_life_care/patient_choice.aspx.
  1. In California, Assembly Bill No. 15, End of Life Option Act  signed into law on October 5th 2015. http://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201520162AB15
  2. In Colorado: End of Life Options Act was approved November 8, 2016. https://ballotpedia.org/Colorado_End_of_Life_Options_Act,_Proposition_106_(2016)
  3. The Netherlands since 1984 (legal) Law: Act of April 1 2002. https://www.government.nl/topics/euthanasia
  4. Switzerland since 1937: https://www.admin.ch/opc/en/classified-compilation/19370083/201501010000/311.0.pdf
  5. Belgium since 2002: http://www.admd.be/Legislation.html
  6. Luxembourg since 2009: http://www.legilux.public.lu/leg/a/archives/2009/0046/a046.pdf

 Q: Who can request a physician-assisted death?

A: In order to meet the legal requirements for assisted dying a patient will need to:

  1. Have a grievous medical condition
  2. The condition must not be remediable using treatment that the patient is willing to accept
  3. The patient’s suffering must be intolerable to the patient
  4. Be an adult able to give consent
  5. Natural death must be in the foreseeable future

 Q: What is the process for physician-assisted death?

A: The process requires the opinion of two physicians, and the patient’s consistent expression of a desire for physician assisted dying over a reasonable period of time.

The following steps must be fulfilled:

  1. The patient must make two oral requests to the physician, separated by a period of time, at least, 10 days;
  2. The patient must provide a written request to the physician, signed in the presence of two independent witnesses, who are not related to the patient and not caregivers;
  3. Two physicians must confirm the patient’s diagnosis and prognosis;
  4. Two physicians must determine whether the patient is capable of making and communicating health care decisions for him/herself;
  5. If either physician believes the patient’s judgment is impaired by a psychiatric or psychological disorder (such as depression), the patient must be referred for a psychological examination;
  6. The physician must inform the patient of feasible alternatives to physician assisted dying including comfort care, hospice care, and pain control;
  7. A patient can rescind a request at any time and in any manner. The physician will also offer the patient an opportunity to rescind his/her request at the end of the waiting period following the initial request to participate.

Q: Do I have to provide a written consent?

A: The patient’s decision to proceed with physician assisted dying requires a formal request, which may be written by the patient or be oral and transcribed by another party. The written request must be dated, signed by the patient, and include the signature of 2 witnesses attesting to the identity of the patient. In both cases, the witness should not be: the attending or consulting physician; a relative; entitled to any portion of the estate; or an owner, operator, or employee of a health care facility where the patient is receiving treatment.

 Q: How do I consent?

A: The patient must be mentally capable of making a free and informed decision at the time of the request and throughout the process. If the physician is unsure whether the patient has the capacity to consent, the patient must be referred to a physician with special expertise in capacity assessments, such as a psychiatrist, neurologist or geriatrician, for further capacity assessment.

Q: Can I consent in an advance directive?

A: No. Physician assisted dying cannot be provided to patients who are not able to give consent including when an alternate gives consent or substitute decision-maker, or through a personal advance directive.

Q: What if I am too ill to travel to see a Doctor?

A: Either the attending physician or the consulting physician, but not both, may providetheir opinion by videoconferencing provided that there is a physician or nurse in physical attendance with the patient. At least one of the attending or consulting physicians must meet with the patient in person.

Q: Do I have to have a terminal illness?

A: No. The words “natural death in the foreseeable future” allow for flexibility. For example, if a person has MS (multiple sclerosis), they can live for decades. However, once he or she is mostly immobile and is at risk for complications such as pneumonia and kidney infections, his or her life expectancy is shorter. If he or she chooses not to accept life-prolonging treatments, such as antibiotics, life expectancy is very short. The patient is not required to undertake treatments that are not acceptable to the him or her. Therefore such a person is eligible for an assisted death.

Q: Who can give a patient a prescription for lethal medication?

A: Physicians and nurse practitioners licenced in the province where the death occurs may provide assisted deaths.

Q: If my doctor does not participate in physician assisted dying, how can I get a prescription?

A: Physicians have the right to decide whether or not to perform physician-assisted dying. The patient must find another physician licensed to practice medicine, who is willing to provide physician-assisted dying.

Physicians who object to physician assisted dying on the basis of their values and beliefs have an obligation to provide an effective transfer of care for their patients by advising patients that other physicians may be available to see them, suggesting the patient visit an alternate physician or service and, if authorized by the patient, transferring the medical records as required.

Q: What kind of prescription will a patient receive?

A: We hope to have a choice between oral and injected medications soon, but at this time, we can only offer IV drugs given by the physician. The doctor will get the medication for you. It will be three drugs: the first causes sleep, the second a coma and the third stops the breathing.

 Q: Can I change my mind?

A: Yes, a patient can rescind a request at any time and in any manner. The attending physician will also offer the patient an opportunity to rescind his/her request at the end of the waiting period following the initial request to participate.

Q: Will insurance cover the cost of physician-assisted death?

A: Yes. Access to physician assisted dying is universally accessible and considered a publicly funded health care service. However, in some circumstances there may be additional costs relating to the request, such as a psychological consult (if required).

Q: Can a patient’s family members request physician-assisted death on behalf of the patient (for example, in cases where the patient is comatose)?

A: No. The law requires that the patient ask to participate voluntarily on his or her own behalf.

Q: What is it like?

You will get a small plastic tube placed in your arm vein. Then the doctor will give 3 medications into the tube. The first is a sedative and you will go to sleep. The second will put you into a coma. Once you are in a coma (about 5 minutes), the doctor will give you a relaxing (paralyzing) medication and you will stop breathing. It all takes less than 10 minutes. You will feel nothing more than going to sleep. Your loved ones will see you go to sleep, then be very still, then your color will change and then your heart will stop and it will be over.