Chapter 7: Preparing for a medically assisted death

Explaining Medical Assistance in Dying (MAID)

The expert says
Tara Noble MSW, RSW on explaining MAID to children(3:22)Video transcript
Tara Noble MSW, RSW on children accessing the Internet about MAID(3:22)Video transcript
Tara Noble MSW, RSW explains that parents aren't sure about what to expect with MAID(3:22)Video transcript
Tara Noble MSW, RSW on the importance of validating your child's feelings(3:22)Video transcript
Dr. Sandy Buchman MD, CCFP (PC), FCFP on helping children understand why someone would choose MAID(3:22)Video transcript
Tara Noble MSW, RSW explains how to distinguish MAID from murder or suicide(3:22)Video transcript

Why does he want to die sooner?

Does it hurt to die?

Will she be scared?

Will it be scary to watch?

What if it doesn't work right?    

There is no cure

The first step in talking with your child about a plan for a medically assisted death is to explain that the person has an illness or disability that cannot be cured and that their overall health means they won't get better.  Help them to understand that the person will die even if they did not have a medically assisted death.  

Older children may be concerned because they hope the person will get better. They may hold on to this hope even though they've been told it isn't possible.

Children are sometimes comforted to know there are rules that ensure a medically assisted death is only provided to someone who cannot recover.

Sometimes people with cancer can be cured. I wish it could be different, but your father’s cancer is stronger than all of the treatments. This means that the cancer will cause his body to stop working and he will die.

What is medical assistance in dying?

The next step is to explain what it means.

When someone has an illness that will cause their body to die, they can wait for this to happen. Or, in some countries, they can ask a doctor to help their body die. The doctor uses medication that stops the body from working. This is done in a way that isn’t painful.   

The choice

When a medically assisted death is considered, help your child to understand that it's not a choice of death over staying alive. The person knows they’re dying and is choosing when and how to die. 

Emphasize that they'd prefer to keep living, be healthy and enjoy more years of life with the child. The illness and their overall condition make this impossible. Explain the ways in which the person is suffering. This can include not being able to enjoy life, not being able to do the things they have always loved to do, and any physical suffering they may be experiencing. Although this may be hard for the child to see and hear, it may help them understand why the person is choosing an assisted death.

The rules

In Canada, a medically assisted death is only allowed if all of the following conditions are met. The person must: 

  • Be over 18.
  • Have a serious and incurable illness, disease or disability.
  • Be in an advanced state of decline that cannot be reversed.
  • Be suffering unbearably from the illness, disease, disability or state of decline.
  • Be at a point where death is reasonably foreseeable.
  • Be aware of all other options, including palliative care.
  • Be assessed independently/separately by two medical doctors or nurse practitioners.
  • Be choosing this for themselves and not under pressure from anyone else.
  • Be mentally able to make this decision for themselves.

A ten-day waiting period is required after the request is made in writing to allow time for the person to reconsider their decision. In rare circumstances, this waiting period can be waived.

In Canada, before MAID medications are administered, the doctor or nurse practitioner asks the person to confirm that they still want MAID. The person must be able to understand the question and respond for MAID to take place.  

For more information on how MAID is administered, please see this video.

Additional information on Medical Assistance in Dying can be accessed through the Government of Canada