Medical assistance in dying rules raise tough questions for health professionals

"Providing excellent health care for patients near the end of life has always been challenging," says Jon Gilchrist, Clinical Ethicist, Covenant Health.

But access to medical assistance in dying (MAID)* has added complexity. “It brings up a whole new set of tough questions for the care team," says Jon. “And the emotions and ethical tensions are just starting to bubble up.” 

He believes good information and support are essential.

“We are like a jetliner coming in for a landing,” says Jon. “The moment the wheels hit the tarmac, they smoke. They smoke because the wheels are trying to get up to speed. We are in that phase with MAID. It is new and we are all trying to get up to speed.”

Tough questions healthcare workers are asked

Jon joined staff from the Banff Mineral Springs Hospital for a Community Ethics Forum about MAID on Nov. 15. More than a dozen local nurses, physicians, social workers and members of the public gathered at the local YMCA to learn about MAID from Alberta Health experts, and to openly share their experiences and questions. 

“Whatever value system they have, healthcare workers are reaching out to us,” explained Lise Lalonde, Navigator, Alberta Health Services. “They want to know how to help patients, what to say to them and how to respond effectively to their questions. The demand for education right now is huge.”

Alberta Health Services has information on MAID online for healthcare workers, patients and families, as well as phone and email contacts. All healthcare workers also have a supportive review process for clinicians each time MAID is carried out. 

“A lot of my work is with staff at all levels,” explains Colleen Torgunrud, Clinical Ethicist, Alberta Health Services. “It is about explaining, as best we can, what this is about and how it came to be. It’s also helping people to unpack what they think about it and why, and to help sort through their chosen careers.”

“We get the sense that the first request a team member gets for MAID is quite jarring for them,” says Jon. “They want to grieve. Because it is a loss. It is also new and different. And, at the same time, it is not our decision. That is a difficult challenge.”

“I want them to know that it is safe to ask questions,” says Jon. “We have people available by phone and email who are prepared and want to help, and will respond without judgment. They are not alone. We are growing through this together.”

*Effective June 6, 2016, based on the Supreme Court of Canada’s decision, physician-assisted death, now known as medical assistance in dying (MAID), ceased to be illegal in Canada in certain circumstances. For rules and processes involving MAID, visit Alberta Health Services. Covenant Health physicians and staff are invited to raise their questions or concerns about MAID with the Clinical Ethics Team. Information is also available on Covenant Health’s home page.  

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