In order for MAID to occur, a series of steps must be followed. In general, it usually takes a minimum of about two weeks to complete the necessary steps, but this timing can increase based on each patient’s circumstance. If it is expected that you will die very soon, then there may be other end-of-life care options that are more appropriate for you.
Step 1: Written Request
- You must make a written request for medical assistance in dying.
- You can access the Ontario Ministry of Health MAID Written Request Form here: Clinician Aid A
- Your signature must be witnessed by two independent witnesses, who must sign the document at the same time.
- An independent witness must be 18 years of age and understand what it means to request medical assistance in dying.
- To be considered independent, the witnesses cannot:
- Benefit from your death;
- Be an owner or operator of a health-care facility where you live or are receiving care;
- Be directly involved in providing you with health or personal care;
There is a provision for patients who cannot sign for themselves.
Step 2: Assessments of Eligibility
You will be assessed by at least two independent assessors. The physician or nurse practitioner who usually looks after you and knows your history and situation best may act as the first assessor.
For MAID to occur, both assessors must agree that you meet the eligibility criteria above. The assessment can take up to 1-2 hours per assessor.
The assessment may include the following:
- A review of relevant medical history and your current medical situation.
- An assessment of your capacity to make decisions.
- A review of your current medications.
- A psychosocial assessment.
- A limited physical examination.
- A detailed explanation of the MAID medications and procedure.
- Answering any questions or concerns you or your family may have.
- Signing a consent form.
Step 3: A Period of Reflection
The law requires that a minimum of 10 clear days must pass between the date that you sign the written request form and the date that MAID occurs. For example, if a patient signs the request form on November 1, then the first possible day when MAID could occur would be November 12. MAID could also occur after this date.
Depending on timing, it is possible that the reflection period may have passed before the medical assessment process has been completed.
The legal requirement for a period of reflection may be shortened in special circumstances if both assessors are in agreement that this is necessary.
Step 4: Provision of MAID
If you are deemed eligible and decide to proceed with MAID, your physician or nurse practitioner will work with you to create a detailed plan. This will include a discussion of the date, location, who will be present, and any special arrangements that are required.
It is necessary for the provider to confirm capacity (see above) and consent immediately prior to provision of MAID. This is an important safeguard for your protection.