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Perspective
September 2017

Medical Assistance in DyingOur Lessons Learned

Author Affiliations
  • 1Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 2Institute of Health Policy Management and Evaluation and Department of Medicine, University of Toronto, Toronto, Ontario, Canada
  • 3Department of Medicine, Mount Sinai Hospital and University Health Network, Toronto, Ontario, Canada
JAMA Intern Med. 2017;177(9):1251-1252. doi:10.1001/jamainternmed.2017.2862

On February 6, 2015, the Supreme Court of Canada struck down the prohibition of physician-assisted dying and ordered the federal parliament to enact legislation to allow it within 12 months.1 On June 17, 2016, Bill C-142 received royal assent, the final step by which a bill becomes both an Act of Parliament and Canadian law. This act made it legal for physicians to provide assistance in dying to individuals in an advanced state of irreversible decline whose natural death was “reasonably foreseeable.” Canada’s health care system rapidly developed protocols for Medical Assistance in Dying, which became known by its acronym, MAID. Like many physicians, each of us felt that changing the law and delivering this service was the right thing to do for the right kind of patient (and there was vigorous debate about who that was). At the same time, we both felt that for at least the near future, we would likely be reluctant to directly or indirectly participate in MAID ourselves.

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