Nova Scotia introduces changes to preserve access to medical assistance in dying

Changes recently announced to the parameters of medical assistance in dying in Nova Scotia should help guard against interruptions to the service.

It comes even as hospitals across the province have changed many aspects of how they operate during the COVID-19 pandemic.

The Nova Scotia Health Authority recently made changes to account for the fact hospitals are heavily restricted to visitors and doctors and nurse practitioners are turning more to telemedicine as a way to reduce face-to-face contact in their offices.

Patients can now use people who work within the health authority to act as a witness to their signature on a consent form, so long as that person isn't directly involved in their care, related to them or included in their will.

"So it's not a great big change, it just allows the process to move more easily," said Dr. Gordon Gubitz, medical director of the province's Medical Assistance in Dying program.

"We're going on as we would normally do."

'Still doing their best'

Gubitz said it's an approach practitioners have used in the past in cases of patients who might not have anyone in their life who can act as a witness.

"In those circumstances we might, and have, made use of Dying With Dignity Canada, who are able to come in and provide those resources."

The visitor restrictions means volunteers for the non-profit aren't able to come into the hospital right now, but organization CEO Helen Long said what's happening in Nova Scotia reflects what's happening right now in most hospitals across the country.

"We know that many of the dedicated MAID providers across Canada, clinicians, are still doing their best to support Canadians and help them through these challenging times," said Long.

These efforts to keep the service running as close to normal reflect that MAID is a legal right for Canadians, said Long. She acknowledged, however, that given the demands COVID-19 is placing on health-care systems, there could be times when things don't go as quickly as they might otherwise.

All patients have been contacted

In an effort to address that, Nicole Phinney, the nurse navigator for the MAID program in Nova Scotia, has been in phone contact with everyone who has requested a referral. Part of that process has been getting a sense of timelines and how urgent things are for each patient.

Although most people who provide the service remain available, Phinney said they are recommending non-urgent cases and assessments be delayed until the situation becomes more pressing.

"So if it's not urgent to have an assessment right now, just because of the risk to the patient and the physician or nurse practitioner, we are trying to limit those non-urgent assessments."

No one in Nova Scotia has missed an assessment or procedure as a result of demands on the system related to coronavirus, said Gubitz, and people can always contact them if their status or plans are changing and need to be expedited.

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