MAiD Paper

Posted: January 4th, 2023

MAiD Paper

Introduction

Over the past decade, Canada’s approach to the choice of end-of-life decisions has undergone significant transformations in light of public opinion and social policy and legal development. Consequently, Canada has heeded the escalating cry for clearness and change in the law to allow individuals to determine the timing of their death. The state acknowledges that the ability to make a choice, for many people, is an essential feature for the right end, especially since medical science has developed to such a heightened level that it is possible to prolong the lives of people amid unremitting sorrow or severe disability. The report pays attention to MAID and the proposed changes that would allow more people to access the vital services provided in a critical situation. It illustrates the importance of endorsing the proposals because they are ethical and acknowledges the individual decisions people make about their health. I support the proposals to expand the health policy because applying moral and nursing values while offering MAID attention increases the patient’s quality of life and restores satisfaction among all parties. 

Understanding of MAiD: Current and Proposed Changes

To pave the way for the new legislative guideline, the House of Commons and Senate jointly formed a special task force to handle the task in January 2016. The committee received much support in their development that offered a joint and person-centered guideline that would change the provision requiring that qualification and process for reaching MAID should differ considerably from one place in Canada to the other (Canadian Nurses Association 2017, p.7). The effort affirmed that nursing is a practice that pays attention to collaborative actions that encourage the most appropriate outcomes for patients (College of Nurses of Ontario 2018, p.3). The committee released a report entitled Medical Assistance in Dying: A Patient-Centered Approach, where it suggested that medical assistance in dying comes in place of physician-assisted death (Canadian Nurses Association 2017, p.7). The report revealed that the Criminal Code permits MAID to be delivered by qualified health personnel who are competent enough to give the most needed services (Canadian Nurses Association 2017, p.7). In April, after the relevant authorities assessed the report (among other information), the government presented Bill C-14, which sought to make new changes to the already existing guidelines and structures (Medical Assistance in Dying) (Canadian Nurses Association 2017, p. 7). 

The presentations illustrates that because territories and provinces have a shared responsibility for health care delivery, they could choose to create additional regulations to make clear the directives influencing MAID delivery. The report guides that should these authorities choose to embrace the relevant adjustments in accordance with the new directives, the practice must happen with considerable facts, care, skill, and firm obedience to any existing procedures, laws, and methods (Canadian Nurses Association 2017, p.8).

The special task force report presents other changes that would improve how nurses and NPs perceive MAID and transform their view of the ethical concerns that may emerge as they care for vulnerable individuals. The regulation would eliminate the requirement for an individual’s natural death to be possibly predictable to qualify for MAID and bring into force a two-track framework to procedural safeguards depending on whether or not a person’s natural end is rationally predictable (Department of Justice 2020). The Bill would eliminate eligibility for persons suffering chiefly from mental sickness (Department of Justice 2020). The legislation widens data generation through the national monitoring regime to provide a more comprehensive picture of MAID in the country (Department of Justice 2020). The recommendations will improve the client’s well-being, promote fairness, and show respect for life, which are among the valuable ethical values identified as essential in providing care (College of Nurses of Ontario 2019, p.4). The joint team hopes the proposed changes will improve MAID services. 

Stance about Expansion of MAiD

The adjustment and expansion of MAID are beneficial. All parties should endorse them to help achieve the country’s objective of transforming end-of-life decisions, palliative care, and other related services. Removing the obligation that the death of those who qualify for MAID must be reasonably predictable will allow many people who suffer from other forms of pain to get the opportunity to evade the problem through a personal decision to end their life (Department of Justice 2020). Before the proposed changes, only those suffering from mental ailments alongside other complications were eligible for MAID. This situation denied many people with different irreversible conditions the chance to end their unbearable pain (Department of Justice 2020). Moreover, expanding data generation through the national monitoring structure to give a clearer perception of MAID in the country will allow individuals and their families to make wise decisions regarding the entire process (Department of Justice 2020). The benefits that the government and vulnerable people are likely to get from the proposed changes call for every stakeholder’s support to attain a situation where the quality of life is upheld to the last minute. 

According to the report by Canadian Nurses Association (2017, p.14), those who qualify for MAID must meet several requirements, including; being a beneficiary of Canadian government’s health cover, being 18 years and above, and proficient enough to make decisions concerning their health and well-being. Eligible persons must have a serious and unalterable ailment, willingly choose, and give consent that they acknowledge what the MAID services entail. An applicant seeking to get the MAID services must wait until the 10-day waiting period elapses, during which the evaluators assess whether one meets the minimum requirements (Government of Canada 2020). Two independent witnesses must also sign the application before the applicant can get the services (Government of Canada 2020). Even though some feel that ten days are more than enough, and that those who need the services and their loved ones suffer significantly before they receive the approval, others think that the duration allows the evaluators much time to assess whether one qualifies.

Making changes that would improve medical assistance in dying is an ethical choice when viewing the move from a utilitarian perspective. The developers of the regulation and other stakeholders must understand that consideration of ethical matters is an essential aspect of offering health care within the therapeutic nurse-client relationship. Utilitarianism is a moral aspect that pays attention to the overall connection of good and bad consequences of a medical practitioner’s professional deeds (Mandal, Ponnambath & Parija 2016, p.5). All the acts are perceived in terms of the outcomes, not based on core moral regulations and guidelines or character traits (Mandal, Ponnambath & Parija 2016, p.5). The theory calls on caregivers to act in a way that produces the best outcome for everyone. It acknowledges that happiness and pleasure are the only things that genuinely have inherent importance. An act is right and ethical insofar it advocates for joy and incorrect if it results in discontentment and unhappiness (Mandal, Ponnambath & Parija 2016, p.6). Utilitarianism also acknowledges that every person’s happiness counts (Mack 2014, p.65; Mandal, Ponnambath & Parija 2016, p.6). For example, providing MAID will instill hope in the person receiving the services and make them feel worthy and appreciated. Besides, the care will restore hope to the victim’s family and friends and be a significant happiness and pleasure source. Consequently, the developers of the act and health caregivers should base their activities following utilitarianism to achieve an outcome that satisfies all sides. 

The proposed changes are geared towards fulfilling other ethical requirements recommended for practice by the Canadian Nurses Association. The decision to make more inclusive directives promotes client choice, which implies self-commitment and encompasses the right to the information and options necessary to make crucial decisions and to agree to or refuse care (College of Nurses of Ontario, 2019, p.6). The choice to provide more people access to MAID supports client choice that patients know the conditions in which they live and their values and beliefs. Consequently, when they have the appropriate information, they can choose what is suitable for them. The suggested changes promote respect for life, which is a significant moral requirement for all practitioners. Respect for life implies that human life is valuable and needs to be protected and handled with attention (College of Nurses of Ontario, 2019, p.8). Respect for life also entails deliberations of the quality of life (Canadian Nurses Association 2017b, p. 11). Embracing and implementing the proposed changes will promote respect for life because more people will have access to MAID and other palliative care forms. Furthermore, the recommendations make it possible to maintain commitments between the caregiver and the patient (College of Nurses of Ontario, 2019, p.9). Nurses will have an obligation to uphold commitments they took as health professionals to serve more persons requiring heightened care when living with a problematic and irreversible condition (Canadian Nurses Association 2017b, p.9). Finally, it is necessary to enact the changes to promote fairness, a fundamental ethical value in nursing. More people will have the chance to get the services, and provinces will adopt similar approaches in offering MAID. Thus, medical practitioners should consider all these ethical aspects while considering complying with the proposals. 

Own Involvement When MAiD Under Advance Request

The Timeframe the Patient had been Approved to be Eligible

I will engage the patients and inform them that they have made the right choice to apply for the service, and restore confidence in them that they have made the right decision. I will also try to find some information about their present and past conditions, and find out if I can use what I learn to enact appropriate changes. Moreover, I will remind the patient that they have the choice to make necessary recommendations that may help to improve the service delivery process in a bid to give proficient, concerned and harmless care as required by the nursing morals and ethical guidelines (Canadian Nurses Association 2017b, p.3). I will inquire some tips from the clinical leader and ensure that my practice during this stage are in line with all directives to achieve the best results.

The Actual Time

I will have to adhere to the ethical guidelines that an RN must follow when involved in a situation with an eligible MAID patient. I will strive to give safe, competent, compassionate, and ethical attention to the client that I handle. My practice would require me to inquire from various sources on promoting health and well-being and how to safeguard and respect informed decision-making by the client and their families. I will abide by the Canadian Nurses Association (2017b, p.14), which requires nurses to honor the patient’s dignity and maintain confidentiality and privacy. I will promote justice in all my activities and relationship with the patient and their families and be accountable in everything I do (Lavoie et al. 2016, p.50). As part of a self-regulating profession, I will follow the Code’s responsibilities and values and abide by the professional laws, guidelines, and morals stimulating ethical service (Canadian Nurses Association 2017b, p.8). My practice will follow the principles that guide the nursing practice while acknowledging that the profession’s objective is to acquire the best possible result for clients (College of Nurses of Ontario, 2018, p.4). I will respect and understand my health care team’s expectations because this enhances how I collaborate with others to arrive at the best outcome (College of Nurses of Ontario, 2018, p.3). I will try to follow all these requirements because I understand that any deviation could result in a poor outcome, not what clients and the profession expect. I believe that following the nursing values and ethical obligations will help me achieve my objectives and will have positive impact on the client. 

Conclusion

MAID provides the opportunity for people to receive quality care even when it is difficult for a person to recover from an illness. More people will get the chance to access attentive care if the proposed changes come to pass. The provinces and territories will no longer provide services differently and prioritize those who have a mental illness. Healthcare givers must consider the directives of utilitarianism to ensure that they act following ethical requirements. The policy developers and medical practitioners should also adhere to client choice’s moral principles, respect for life, and maintaining commitment. 

References

Canadian Nurses Association. (2017). National nursing framework on medical assistance in dying in Canada. Ottawa: Canadian Nurses Association. https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/cna-national-nursing-framework-on-maid.pdf

Canadian Nurses Association. (2017b). Code of ethics. Ottawa: Canadian Nurses Association. https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/code-of-ethics-2017-edition-secure-interactive.pdf

College of Nurses of Ontario. (2019). Ethics. Ontario: College of Nurses of Ontario. https://www.cno.org/globalassets/docs/prac/41034_ethics.pdf

College of Nurses of Ontario. (2018). RN and RPN practice: The client, the nurse and the environment. Ontario: College of Nurses of Ontario. https://www.cno.org/globalassets/docs/prac/41062.pdf

Department of Justice. (2020). Government of Canada reintroduces proposed changes to medical assistance in dying legislation. Retrieved November 9, 2020, from https://www.canada.ca/en/department-justice/news/2020/02/government-of-canada-proposes-changes-to-medical-assistance-in-dying-legislation.htmllegislation-817788119.html

Government of Canada. (2020). Medical assistance in dying. Retrieved November 25, 2020, from https://www.canada.ca/en/health-canada/services/medical-assistance-dying.html

Lavoie, M., Godin, G., Vezina-Im, L. A., Blondeau, D., Martineau, I., & Roy, L. (2016). Psychosocial determinants of nurses’ intention to practise euthanasia in palliative care. Nursing Ethics, 23, 48-60. doi:10.1177/0969733014557117

Mack P. (2014). Utilitarian ethics in healthcare. International Journal of Computer Internet Management 12, 63-72. doi: 10.4103/2229-5070.175024

Mandal, J., Ponnambath, D., & Parija, S. (2016). Utilitarian and deontological ethics in medicine. Tropical Parasitology 6 (1), 5-7. https://www.tropicalparasitology.org/article.asp?issn=2229-5070;year=2016;volume=6;issue=1;spage=5;epage=7;aulast=Mandal