Interpreting Eligibility Under the Medical Assistance in Dying Law: The Experiences of Physicians and Nurse Practitioners

Abstract

This study examines the experiences of physicians and nurse practitioners interpreting the statutory criteria determining patient eligibility for Medical Assistance in Dying (MAiD). The Criminal Code sets out what qualifies as “a grievous and irremediable medical condition”, which includes the requirement that a patient’s “natural death has become reasonably foreseeable” (NDRF). The Superior Court of Quebec struck down the provision as unconstitutional and the government responded by introducing Bill C-7 which now deploys the NDRF criterion in new ways. Ambiguity and controversy have attached to the phrase since the Government introduced Bill C-14 before Parliament in 2016. From January to March 2019, we conducted semi-structured interviews with twenty-four Canadian MAiD assessors and providers to find out how they interpret the relevant federal and provincial legislative provisions. Respondents included 9 doctors from Quebec where the provincial law differs from the Criminal Code. The article identifies differences in the eligibility regimes, while providing a detailed analysis of how health care practitioners interpret and apply the statutory requirements to determine patient eligibility for MAiD. Our findings shed new light on Truchon and Bill C-7, while offering insight into the on-the-ground experiences of health care professionals in this changing field of law.