Medical assistance in dying and end‑of‑life decisions
Find eligibility information for medical assistance in dying (MAID) and how and where you can receive it.
About medical assistance in dying
If you’re suffering from a grievous (very serious) and irremediable (impossible to reverse) medical condition, you can talk to your physician or nurse practitioner about your options for treatment and care. These may include:
- counselling services
- mental health supports
- addiction services
- community services
- palliative care (care to maintain or improve your quality of life)
- psychological supports
- spiritual care
- disability supports
- community supports
- medical assistance in dying (MAID)
Considerations for MAID
Prior to making a decision about MAID, your physician or nurse practitioner must also offer you the opportunity to consult with professionals who provide the above services, as available and applicable. You will have time to think about your decision and may change your decision at any time.
The federal government, through the Criminal Code of Canada, is responsible for determining the eligibility criteria and safeguards for MAID. Ontario adheres to the requirements as dictated by federal legislation, to assess an individual’s eligibility.
Finding help
Before making a decision, speak with your physician or nurse practitioner. Your physician or nurse practitioner must take all necessary measures to make sure you:
- understand your options when considering MAID
- can communicate your decision, which may include bringing in an interpreter or any other help you may need
- understand that this is your decision – only you can make the decision to request and, if eligible, receive MAID
Some physicians or nurse practitioners may not want to provide MAID for reasons of conscience or religion. In this situation, they must refer you in a timely manner to another physician or nurse practitioner. Additionally, you can submit a self-referral to the care coordination service.
Contact the care coordination service
The provincial care coordination service provides individuals, caregivers, and providers with information about MAID and other end-of-life options, and referrals for MAID services. It accepts self-referrals and can connect you with a dedicated physician or nurse practitioner who can complete an assessment to determine your eligibility for MAID.
When you call the care coordination service you will speak to someone who can:
- give you more information about MAID and other end-of-life options, including palliative care
- connect you with a physician or nurse practitioner who provides MAID, such as assessments or dispensing drugs
The care coordination service:
- can be reached toll free at
1-866-286-4023 orTTY: 1-844-953-3350 - operates 24 hours a day, 7 days a week
- offers referral services which are available Monday to Friday, 9 a.m. to 5 p.m.
- is available in English and French
- can arrange service in over 300 other languages if requested
Even with this care coordination service available, physicians and nurse practitioners who choose to not provide medical assistance in dying must still refer you to another provider.
Eligibility
To receive MAID in Ontario, you must:
- be eligible for publicly funded health care services in Canada
- be 18 years of age or older
- be capable of making health care decisions
- be able to provide informed consent, which means that you have given permission after you have received all the information you need to make your decision
- voluntarily request MAID
- have a grievous and irremediable medical condition, which means you:
- have a serious and incurable illness, disease or disability
- are in an advanced state of irreversible decline in capability
- are enduring physical or psychological suffering, caused by the medical condition or the state of decline, that is intolerable and cannot be relieved
A physician or nurse practitioner will determine if you meet all the eligibility requirements. If you do, a second physician or nurse practitioner must complete another assessment to confirm that you meet all the eligibility criteria.
Those approved for MAID may be eligible to be an organ or tissue donor. Register to donate at BeADonor.ca and ask your healthcare provider to contact Trillium Gift of Life Network (TGLN). As part of the standard process for patients nearing the end of life, your health care team may contact TGLN on your behalf.
Mental disorders
Under Federal legislation, those who suffer solely from a mental disorder as the sole underlying condition are not currently eligible for MAID. Learn more about Canada's laws on MAID.
If you have an immediate emergency, please call
If you are thinking of suicide or worried about someone who is, the
Visit ConnexOntario at or call
Where you can receive assistance
You can ask to receive MAID no matter where you live or receive care in Ontario. This includes:
- a hospital
- a long-term care home
- a hospice or palliative care facility
- your home
Some health care facilities may choose not to provide MAID or have limitations on how it is provided. We encourage facilities to make this information available, so you know your options. Please contact your desired facility for clarification if this information is not available.
How to receive assistance
Make a request
You must make your first request to receive MAID either verbally or in writing to your physician or nurse practitioner.
A physician or nurse practitioner will determine if you meet the eligibility requirements. If you do, another physician or nurse practitioner must provide a written opinion which confirms that you meet all of the eligibility criteria.
If your natural death is not reasonably foreseeable, one of the two providers confirming your eligibility must have expertise in the condition that is causing your suffering. In cases where neither provider has expertise, one of the two providers must consult with a third provider with that expertise and share the results with the other providers.
Before MAID can be administered, your written request must be completed, dated, and signed. You will need an independent witness to confirm the signing and dating of the request and they must understand what they are signing. An independent witness must be at least 18 years of age and understand that MAID is a procedure that will end your life.
To be considered independent means that the witness cannot:
- benefit from your death
- be an owner or operator of a healthcare facility where you live or are receiving care
- be an unpaid caregiver
Receive assistance
A physician or nurse practitioner will either:
- administer the drugs for you
- write a prescription for drugs that you can take on your own
If you choose to self-administer MAID, a healthcare provider can be present with you during administration to ensure your safety and comfort.
You have time to think about your decision
Once 2 physicians or nurse practitioners have determined you are eligible for MAID, you still have time to consider your decision. You may also withdraw your request at any time.
If your natural death is not reasonably foreseeable, you must wait at least 90 days between the date on which your first assessment began and the day on which MAID is provided. This gives you time to think about your decision.
In cases where death or loss of capacity to provide your informed consent is imminent, physicians or nurse practitioners may approve a shorter waiting period if they consider it appropriate in the circumstances.
Withdraw your request at any time
Right before administering MAID, your physician or nurse practitioner will:
- give you another opportunity to withdraw your request
- confirm that you are still mentally capable of making this choice
- get your final, expressed consent to proceed (except if the final consent requirement is waived)
Waiving final consent
The federal law requires a person to provide their consent to MAID immediately before it is provided.
However, if you are no longer able to consent, your physician or nurse practitioner may provide MAID to you if all of the following conditions are met:
- your natural death has become reasonably foreseeable (a prognosis of the specific length of time that you have remaining is not required)
- you are eligible for and approved to receive MAID
- you have a scheduled date with a specific provider (in writing) for receiving MAID
- you have been informed by the physician or nurse practitioner that you are at risk of losing decision-making capacity before the scheduled date
- you consent to the physician or nurse practitioner administering a substance to cause your death on the scheduled date if you do not refuse or resist (by words, sounds or gestures) having the substance administered
The request to waive final consent must be received in writing and your provider must agree to administer a substance to cause your death on a specified day.
If you have the capacity to consent on the day MAID is administered, the provider must:
- give you the opportunity to withdraw the request
- ensure that you express consent to receive MAID