Health Professionals

Frequently asked questions

What did the Supreme Court of Canada rule in Carter v. Canada (Attorney General)?
The Supreme Court decided that the law (Criminal Code) making it a crime for a physician to assist another person to commit suicide, in certain specific circumstances, violated the right to life, liberty and security of the person under the Charter of Rights and Freedoms.

Back to top

What is the status of the law on medical assistance in dying?
On 17 June 2016 the federal government passed legislation that details the circumstances in which a person may be eligible for an assisted death.

Back to top

Who is eligible for medical assistance in dying in Canada?
According to federal law a person may receive medical assistance in dying only if they meet all of the following criteria:

  1. they are eligible for health services funded by a government in Canada
  2. they are at least 18 years of age and capable of making decisions with respect to their health
  3. they have a grievous and irremediable medical condition defined as including ALL of the following:
  4. They have a serious and incurable illness, disease or disability
  5. They are in an advanced state of irreversible decline in capability
  6. Their illness, disease or disability or state of decline causes them enduring physical or psychological suffering that is intolerable to them and that cannot be relieved under conditions that they consider acceptable
  7. Their natural death has become reasonably foreseeable, taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining.
  8. they have made a voluntary request for medical assistance in dying that, in particular, was not made as a result of external pressure; and
  9. they provide informed consent to receive medical assistance in dying after having been informed of the all the means that are available to relieve their suffering, including palliative care.

Back to top

What is the difference between euthanasia and physician assisted suicide? Are they the same as physician assisted dying or medical assistance/aid in dying?
The Supreme Court of Canada considered the terms "physician assisted dying, medical assistance in dying and medical assistance/aid in dying" to be equivalent.

The federal law describes and allows for two types of medical assistance in dying. They include where a physician:

  1. directly administers medication (intravenously) that causes death - commonly called voluntary euthanasia or clinician-assisted medical assistance in dying
  2. provides or prescribes medication that the patient takes themselves (orally) to cause their own death - commonly known as assisted suicide or self-administered medical assistance in dying

NOTE: At present only intravenous medications are available in Manitoba for medical assistance in dying.

Back to top

What are the medications used for medical assistance in dying?
That information will not be provided publicly. Health care providers may contact the provincial medical assistance in dying clinical team (who have developed a standardized prescription) for further information.

Back to top

How is medical assistance in dying different from withholding or withdrawing life sustaining treatment?
Medical assistance in dying is an intervention intended to cause death. Withholding and withdrawing life sustaining treatments are decisions made to stop or not start interventions that would prevent an individual from dying. Withholding/withdrawing life sustaining treatments has occurred for many years in Manitoba and is not affected by this decision.

Back to top

How does the option of medical assistance in dying affect medical practice?
Conversations around suffering and end of life care do not need to change. Consideration by a patient of medical assistance in dying should not alter the treatment options offered and discussed.  Please see the Advice for Health Professionals page  and Standards of Practice page for additional information.

Health care providers who wish to participate in the medical assistance in dying process with their patients can work alongside the provincial medical assistance in dying clinical team.

Back to top

I work at a faith-based facility and I don’t believe our faith-based mandate aligns with the practice of medical assistance in dying - how will the WRHA address that?
The WRHA respects the position of faith-based facilities and will continue to work collaboratively with those sites as partners.

While you or your facility may object to medical assistance in dying, conversations around suffering and end of life are a normal part of the health care provider-patient interaction and may lead to better care for the patient. These conversations can be had outside of the formal medical assistance in dying process.

The WRHA expects any and all staff who have conscience-based objections to medical assistance in dying to refer patients to the following resources so that they may obtain the information they need to make their decision:

  • the chief medical officer/nursing officer of their site or
  • the provincial medical assistance in dying clinical team at: maid@wrha.mb.ca, 204-926-1380 or toll free 1-844-891-1825 or
  • Health Links – Info Santé 204-788-8200 or toll free 1-888-315-9257

Back to top

What should I say to patients and families who ask me to assist them in dying?
All health care providers are expected to respond compassionately and respectfully. The WRHA has asked that staff have conversations with patients to explore why they want medical assistance in dying and explore all options that may address their suffering. If a patient wants to pursue medical assistance in dying, we ask staff to either refer these requests to the chief medical officer/nursing officer of their site (through a manager or supervisor), share the contact information for the provincial medical assistance in dying clinical team with the patient or send a referral directly to the team.

Back to top

I have conscience-based objection to medical assistance in dying. What are my options if I am asked to assist in or provide information about medical assistance in dying?
No one will be compelled to provide or participate in medical assistance in dying. We do, however, expect that all patients be provided access to resources and information on medical assistance in dying. If approached by a patient seeking information on medical assistance in dying, please reach out to the chief medical officer/nursing officer at your site (through a manager/supervisor or other leadership as appropriate) OR refer the patient to www.wrha.mb.ca/maid or Health Links-Info Santé to find out more information on their own.

It is important to remember, health care providers with conscience-based objection may still explore the reason for a request for medical assistance in dying as it may reveal opportunities to discuss other ways of relieving a patient’s suffering.

Back to top

I feel that medical assistance in dying can fit into my practice. What are my options?
All health care providers interested in providing medical assistance in dying should contact the provincial medical assistance in dying clinical  team.

Back to top

Have we had any requests in Manitoba for medical assistance in dying?
Yes. There have been, and continue to be, requests for and provision of medical assistance in dying within the province.

Back to top

How is medical assistance in dying being provided in Manitoba?
In Manitoba, there is a provincial medical assistance in dying clinical team comprised of physicians, nurses, social workers, pharmacists and a speech language pathologist. Currently, only this team may assess for eligibility and provide medical assistance in dying within regional health authority facilities. Although this team is set up to provide all parts of assisted death, they are willing and able to work alongside the patient’s existing healthcare team.

Back to top

Is medical assistance in dying different from Palliative Care?
Yes. In palliative care, medications and treatments are given to relieve symptoms but the intention is not to cause death. In medical assistance in dying, the patient must be assessed for eligibility and if they are eligible for and choose to have medical assistance in dying the medications given are intended to cause death.

A patient may receive both palliative care and medical assistance in dying.

Back to top

Can a person who receives medical assistance in dying donate their organs?
It may be possible for some patients who receive medical assistance in dying to participate in organ and/or tissue donation. This would need to be evaluated and determined on a case by case basis.

Back to top

Who should I contact with more questions?
Call 204-926-1380 or email maid@wrha.mb.ca.