What Does an Ideal Model for Medical Assistance in Dying (MAiD) Coordination Look Like?

Abstract

Medical Assistance in Dying (MAiD) is a legal medical procedure in Canada governed by federal and in some instances, provincial laws. MAiD is permitted under strict legal and procedural safeguards for individuals who meet specific eligibility criteria. When MAiD is done well, the MAiD team works not only to ensure that all federally legislated requirements are met in a timely, efficient, and effective manner, but also that the person requesting MAiD is kept at the centre of the care circle ensuring compassionate patient care is reflected throughout the process. The coordination of MAiD Care differs across provinces, territories, regions, and organizations within these areas. Some provinces have MAiD Coordination Centres (MCCs) where all MAiD requests filter through for the entire province. Other provinces have similar concepts but are regionally organised. There are some areas in the Canada where access to MAiD coordination depends on specific organisations individual MAiD response and whether or not they have MAiD teams with coordinators. Even the title attributed to these role(s) vary across and within these areas. MAiD Care Coordinator, MAiD Coordinator, Nurse MAiD Navigator are just a few examples of the various titles attributed to MAiD coordination in Canada. However, despite the differences, one common thread unites ideal MAiD Coordination: its essential and pivotal role in helping to reduce barriers to MAiD care. The authors of this paper advocate for the ‘ideal’ scenario, which would involve standardizing access to aspects of MAiD coordination across all provinces in the form of a MAiD Coordination Center (MCC). This ideal scenario would ensure access to consistent education, clinical leadership, interprofessional involvement, supportive data/quality improvement oversight initiatives, and the actual process of coordination for all involved in MAiD care. Ideally, giving all health care providers and patients involved in MAiD Care access to standardized supports while maintaining the flexibility to respond to the nuances of their specific region or organization. Acknowledging the need for localized coordination and provincial, territorial difference will ensure the diversity that exists across Canada’s healthcare and within each region can be honoured.