About medical assistance in dying

If you’re suffering from a grievous (very serious) and irremediable (impossible to recover from) medical condition, you can talk to your doctor or nurse practitioner about your options for treatment and care. These may include:

  • counselling services
  • mental health and disability support services
  • community services
  • palliative care (care to maintain or improve your quality of life)
  • psychological supports
  • spiritual care
  • disability supports
  • community supports
  • medical assistance in dying

Prior to your making a decision about medical assistance in dying, your doctor or nurse practitioner must also offer you the opportunity to consult with professionals who provide the above services, as available and applicable. Patients will have time to think about their decision and may change their decision at any time.

Medical assistance in dying is a complex and deeply personal issue governed by the Government of Canada. Learn about Canada’s laws about medical assistance in dying.

Finding someone to help

Your doctor or nurse practitioner must take all necessary measures to make sure you:

  • understand your options when considering medical assistance in dying, and
  • can communicate your decision. This includes bringing in an interpreter or any other help you may need

Some doctors or nurse practitioners may not want to provide medical assistance in dying for reasons of conscience or religion. In this situation, they must refer you in a timely manner to another doctor or nurse practitioner.

Contact the care coordination service

The medical assistance in dying care coordination service is in place to support clinicians, patients and caregivers.

When you call the care coordination service you will speak to someone who can:

  • give you more information about medical assistance in dying and other end-of-life options
  • connect you with a doctor or nurse practitioner who provides medical assistance in dying services, such as assessments or administering drugs

Care coordination service:

  • can be reached at 1-866-286-4023 or TTY: 1-844-953-3350
  • the information line operates 24 hours a day, 7 days a week
  • referral services are available Monday to Friday, 9 a.m. to 5 p.m.
  • is available in English and French
  • can arrange service in other languages if requested

Even with this care coordination service available, doctors and nurse practitioners who choose to not provide medical assistance in dying must still refer you to another provider.

Eligibility

To receive medical assistance in dying in Ontario, you must:

  • be eligible for publicly funded health care services in Canada
  • be 18 years of age or older
  • be capable of making health care decisions
  • be able to provide informed consent, which means that you have given permission after you have received all the information you need to make your decision
  • voluntarily request medical assistance in dying
  • have a grievous and irremediable medical condition, which means you:
    • have a serious and incurable illness, disease or disability
    • are in an advanced state of irreversible decline in capability
    • are enduring physical or psychological suffering, caused by the medical condition or the state of decline, that is intolerable and cannot be relieved

A doctor or nurse practitioner will determine if you meet all the eligibility requirements. If you do, a second doctor or nurse practitioner must complete another assessment to confirm that you meet all the eligibility criteria.

If you are suffering solely from a mental illness (not in combination with another condition) you are not currently eligible for medical assistance in dying. However, the Government of Canada is conducting an independent, expert review of recommended protocols, guidance and safeguards for requests for medical assistance in dying by people who are suffering from mental illness. Recommendations are anticipated in by March 17, 2022.

Where you can receive assistance

You can ask to receive medical assistance in dying no matter where you live or receive care in Ontario. This includes:

  • a hospital
  • a long-term care home
  • a hospice or palliative care facility
  • your home

Some facilities may choose not to provide medical assistance in dying or have limitations on how it is provided. We encourage facilities to make this information available, so you know your options.

How to receive assistance

Make a request

You must make a written request to receive medical assistance in dying. The written request must be witnessed, signed and dated by one independent witness.

Submit your written request to your physician or nurse practitioner.

A doctor or nurse practitioner will determine if you meet the eligibility requirements. If you do, another doctor or nurse practitioner must provide a written opinion which confirms that you meet all of the eligibility criteria.

If natural death is not reasonably foreseeable, one of the two practitioners confirming your eligibility must have expertise in the condition that is causing your suffering. In cases where neither practitioner has expertise, one of the two practitioners must consult with a third practitioner with that expertise and share the results with the other practitioner.

Receive assistance

A doctor or nurse practitioner will either:

  • administer the drugs for you
  • write a prescription for drugs that you can take on your own

You have time to think about your decision

Once your request for medical assistance in dying is approved, you still have time to consider your decision. You may also withdraw your request at any time.

If your natural death is not reasonably foreseeable , you must wait at least 90 clear days (not counting the first and last days) between submitting your written request and receiving medical assistance in dying. This gives you time to think about your decision.

In cases where death or loss of capacity to provide informed consent is imminent, the doctors or nurse practitioners may approve a shorter waiting period they consider appropriate in the circumstances.

Withdraw your request at any time

Right before administering medical assistance in dying, your doctor or nurse practitioner will:

  • give you another opportunity to withdraw your request
  • confirm that you are still mentally capable of making this choice
  • get your final, expressed consent to proceed (except if the final consent requirement is waived)

Waiving final consent

The law requires a patient to provide their consent to medical assistance in dying immediately before it is provided.

However, your doctor or nurse practitioner may provide medical assistance to a you if you are no longer able to consent if all of the following conditions are met:

  • your natural death has become reasonably foreseeable (a prognosis of the specific length of time that you have remaining is not required)
  • you are eligible for and approved to receive medical assistance in dying
  • your procedure for medical assistance in dying has been scheduled with a specific provider (in writing)
  • you have been informed by the doctor or nurse practitioner that you are at risk of losing decision-making capacity before the scheduled
  • you consent to the doctor or nurse practitioner administering a substance to cause your death on the scheduled date
  • you do not refuse or resist (by words, sounds or gestures) having the substance administered

The request to waive final consent must be received in writing and your practitioner must agree to administer a substance to cause your death on a specified day.

If you have the capacity to consent on the day of the medical assistance in dying procedure, the practitioner must:

  • give you the opportunity to withdraw the request
  • ensure that you express consent to receive medical assistance in dying