Medical Assistance in Dying (MAiD)

On February 22, 2024, the Newfoundland and Labrador College of Nurses’ Board approved an edit to the current College MAID document as a result of the release of the new Federal Model Practice Standard for MAID in Spring 2023 and approved the adoption of the Federal Model Practice Standard for MAID as an additional practice requirement for NPs when providing MAID. With the release of the Federal Model Standard, NPs, who choose to provide MAID, will be expected to be knowledgeable of and adhere to the requirements outlined in these two documents along with any relevant employer policies/requirements and any other federal and/or provincial legislative requirements.

The NL College of Registered Nurses¹ of is the regulatory body for nurses in Newfoundland and Labrador (NL). The mandate of the College is to protect the public through self-regulation of the nursing profession in accordance with the Nurses Act, 2024.

The purpose of this practice guideline is to outline the practice expectations of NPs providing Medical Assistance in Dying (MAID) or nurses aiding in MAID. Nurses are required to practise within their scope of practice and individual competence, in accordance with legislative and regulatory requirements and employer/organizational policies when providing or aiding MAID. If nurses have questions or concerns about how MAID legislation applies to their nursing practice or about liabilities related to MAID, they are encouraged to speak to their employer or seek legal advice (e.g., Canadian Nurses Protective Society (CNPS) or the employer and/or personal legal counsel).

MAID legislation was first introduced on June 17th, 2016 and has been updated several times since then through Amendments to the Criminal Code of Canada (Criminal Code or CCC). Content of this document reflects the latest Amendments to the CCC that took effect March 17th, 2021. Nurses need to be aware that changes may still occur in legislation with resultant changes in the College’s MAID document. Nurses must ensure they review the most current sections of MAID legislation (CCC) and the most current version of the College’s MAID document before providing or aiding in MAID.

In this document, the College has included information on:

• Legislative changes to the Criminal Code related to MAID
• General nursing accountabilities
  • Ability of NPs to advise of potential for MAID based upon certain criteria
• NPs providing MAID
  • Scope of practice of NPs providing MAID
  • Eligibility criteria for MAID
  • Ensuring safeguards are met when natural death is reasonably foreseeable or when natural death is not reasonably foreseeable
  • Duties of the first and second MAID clinicians
  • MAID Medication
  • Documentation
  • Reporting Requirements (updated)
• Nurses Aiding in MAID
  • Providing nursing support
  • Preparing MAID medication
  • Acting as an independent witness
  • Documentation
  • Self-care
  • Conscientious objection

In addition, excerpts from the Amendments of the Criminal Code of Canada related to MAID that came into effect on March 17th, 2021 are included in this document.

NOTE: On February 1, 2024, the Federal Government announced that it would postpone the eligibility date for persons suffering solely from a mental illness until March 17, 2027.

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