Medically Assisted Death and the Law

Over 1,000 gravely ill Canadian adults have accessed Medical Assistance In Dying (MAID) to end their lives since the medical procedure became legal across Canada in June 2016, and experts expect these numbers to rise. It is reported that, on average, four Canadians have a medically assisted death every day; the average age of individuals accessing MAID is 72, evenly split between men and women. More than half of the individuals cite cancer as the reason for accessing assistance, while almost a quarter cite degenerative diseases, such a multiple sclerosis.

The Government of Canada requires that all of the following conditions be met in order to qualify for MAID. The individual must:

  • be at least 18 years old and mentally competent and capable of making health care decisions for themselves
  • have a grievous and irremediable medical condition
  • be eligible for health services funded by the federal government, or a province or territory; visitors to Canada are generally not eligible for medical assistance in dying
  • make a voluntary request for medical assistance in dying that is not the result of outside pressure or influence
  • give informed consent to receive medical assistance in dying

There are checks and balances involved with this process as well, including a period of at least 10 days between the day on which the request for medical assistance in dying is signed, and the day on which medical assistance in dying is provided. 

On December 7, 2016, the Ontario government introduced legislation that if passed, will support the implementation of medical assistance in dying by providing more details and protection for patients, their families, and their health care providers. Other provinces have done the same.

The Ontario Medical Assistance in Dying Statute Law Amendment Act would ensure that benefits such as insurance payouts and workplace safety benefits are not denied solely due to a medically assisted death.

The legislation also states that associated costs, including drugs, will be covered.

  • Physician and nurse practitioner activity for medical assistance in dying will be funded through existing OHIP (applicable provincial coverage)
  • Existing compensation mechanisms will also be employed to compensate pharmacists and other health care professionals involved in the provision of medical assistance in dying
  • The cost of drugs for all eligible patients will also be covered for both clinician-administered and patient self-administered medical assistance in dying, in any location

Cowan Insurance Group reached out to a variety of Canadian insurance carriers to confirm their approach. Carriers responded that they would follow CLHIA’s guidelines by province, and therefore not exercise the two-year suicide clause (if applicable) for MAID deaths. One response, however, made the answer clear. “A person who received Medical Assistance in Dying is considered to have died as the result of the underlying injury or illness (not as a result of suicide). Therefore, as long as all other requirements are met, their death claim would be considered an eligible claim under any and all Life or Optional insurance policies.” 

Please feel free to reach out to your Group Benefits Consultant for updates on specific insurance carrier responses. 

https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

https://news.ontario.ca/mohltc/en/2016/12/ontario-introduces-legislation-on-medical-assistance-in-dying.html

http://www.theglobeandmail.com/news/national/at-least-970-people-received-an-assisted-death-in-canada-in-2016-report/article34823863/

https://www.thestar.com/news/queenspark/2016/06/06/drugs-for-doctor-assisted-death-will-be-free-in-ontario.html