Formal network of docs offering medical assistance in dying is in the works for northeastern Ontario

For those in Sudbury and District seeking a doctor's help to die, it may soon get a little easier to find one who is trained.

About 40 doctors and nurse practitioners in the region are now trained to offerMedical Assistance in Dying (MAID), after they had specialized training last fall in Sudbury from the Canadian Medical Association.

The Supreme Court of Canada ruled in June, 2016 that medical assistance in dyingisa constitutional right, under BillC-14.

Between thenand now, there has only been an informal network for people seeking medically assisted death, saidDr. Paul Preston, Vice President of Clinical for the North East Local Health Integration Network, and anadvocatefor access for those seeking a doctor's help with dying.

Referrals happen when family practitioners who may beuncomfortable with the request,direct the patientto another doctor.

"I think most communities, if their doc wasn't involved personally, then they would know of a doc that was," Preston says.

The North East LHIN is in the initial stages ofcreating a formalnetwork for these referrals.

"There's going to be more of a local [network], and an evolving thing will be recognizing these very local referral networks thathave been informal so far," he said. "So that theLHINcan be involved in helping access these providers."

He adds that many doctors and nurses who help people with dying don't want their names on a published list, nor do they want to provide service outside their catchment area. So the LHINstill needs to work out the details for how thenetwork will operate or who will have access to it.

Doc-to-doc mentorship

Dr. Preston has been offering assisted-dyingto patients since it became a constitutional right almost two years ago.

Since then he says he'soffered advice to other providers, including a physician who had few options.

"Adoc that really wanted to help provide this service for hispatient in a remote community, that had otherwise no access.I just helped point out all the logistical little steps that they have to consider, that aren't in the paperwork."

Preston says the Ontario College of Family Physicians (OCFP)is also setting up a formal mentorship program for doctors new to providing medically assisted death.

"There will be a mentor and a mentee.There will be obviously some baseline education, and then some one-on-one discussions and close inter-connectedness, trying to doit on a regional or an approximate as possible level," hesays.

OCFP has experience with mentorship programs for other conditions.

Health care changing to include MAID

According to Health Canada, apatient who would like medical assistance in dying must be assessed by two independent physicians or nurse practitioners to determine if they are eligible. The patient'squality of life has to be reduced by a terminal disease.

Preston says most who seek out assisted-dying don't do it because of pain, but rather for emotional relief.

"The first step is for people to talk to their family doctor."

He added that if that doesn't work, there is a provincial call line to connectto the LHINcare coordination service:1-866-286-4023.

"We're getting there. [Medical assistance in dying] isa brand new thing so it's a lot of change in the [health care] system to make it be connected to the system and be sustainable."