首页|Final consent, advance consent and alleviating suffering in frail adults requesting MAiD
Final consent, advance consent and alleviating suffering in frail adults requesting MAiD
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Cma-Canadian Medical Assoc
We thank Engelhart and colleagues1 for bringing forward an important topic in their article published in CMAJ. The association between frailty and eligibility for medical assistance in dying (MAiD) requires attention, as the authors state, especially in light of changes to the Criminal Code of Canada, brought about by Bill C72 receiving Royal Assent in March 2021. We wish to highlight 2 important points of clarification. First, the authors state, “Bill C-7 also permits MAiD through an advanced directive if eligibility was determined when the person was capable.”1 The Criminal Code3 does not actually allow for an advance directive for MAiD; rather, it allows for a waiver of final consent and advance consent. The former is permitted only for eligible persons whose natural death is reasonably foreseeable, and must be accompanied by a written arrangement with the provider identifying a specific date for provision, among other requirements. This act of waiving final consent is later referred to as “advance consent” in the Code. In addition, the Code allows for advance consent in cases of failed selfadministration of MAiD medications.
Jill Oliver、Angel Petropanagos、Paula Chidwick
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Community ethicist, Ethics Quality Improvement Lab, William Osler Health System, Brampton, Ont.