Assisted death
Medical Assistance
in Dying: Early
Lessons Learned
In accordance with Ontario’s Coroners Act, the Office of the Chief Coroner is notified
of all medically assisted deaths in the province. Key issues and ‘early lessons learned’
identified by the Office of the Chief Coroner are provided below, with information
about resources that will assist physicians in fulfilling their professional and legal
obligations relating to medical assistance in dying.
1 Record Keeping
Good record keeping is critical for
effective practice in the context of
medical assistance in dying.
In keeping with physicians’ professional and
legal obligations with respect to medical record keeping, all physician-patient encounters
concerning medical assistance in dying must
be documented. Physicians’ medical record
keeping obligations are set out in the College’s
Medical Assistance in Dying and Medical Records policies. In keeping with these
obligations, physicians, who are involved in
assessing a patient’s eligibility for medical
assistance in dying must document each element of the patient’s assessment, and include
a copy of their written opinion in the medical
record. Further, all oral and written requests
for medical assistance in dying, and the dates
of these requests, must be documented in the
medical record.
To assist with record keeping in the medical
assistance in dying context, the Ministry of
Health and Long-Term Care has developed
forms for use by physicians and/or patients
where a medically assisted death is sough t.
These forms serve as supplementary aids and
help promote good record keeping. When
using these aids, physicians are reminded that
the medical record keeping obligations as set
out in the College’s Medical Records policy
continue to apply.
To access these forms, please click on the
Early Lessons Learned document in the College’s Medical Assistance in Dying policy
page at www.cpso.on.ca.
2 Reflection Period
The 10-day period of reflection
between the date medical assistance
in dying is requested and the date it is
provided, may only be shortened in two
circumstances.
The requirement for a reflection period is
set out in federal law. It is captured in Step 6
of the Process Map included in the College’s
Medical Assistance in Dying policy.
Federal law requires that 10 days pass
between the day on which the patient’s written request for medical assistance in dying is
made, and the day on which medical assistance in dying is provided. Physicians are
reminded that, under law, the 10-day period
may only be shortened if both the providing
Issue 3, 2016 Dialogue
29