Medical assistance in dying - Information for health-care providers
Medical assistance in dying is a new health-care service in B.C. and health-care providers may have questions about the administrative steps in providing this service. See below for information on some of the common administrative processes involved in providing medical assistance in dying.
For information on practice standards, health-care providers should contact their provincial regulatory college.
How do I bill MSP for medical assistance in dying services?
Doctors of BC and the Ministry of Health are working to determine appropriate fee amounts for medical assistance in dying. In the interim, existing fees for similar services will be used. Doctors can bill per the fee structure laid out in the following document:
What forms must be completed and where can I find them?
Provincial standardized forms for medical assistance in dying are now available on the Ministry of Health’s website (see quick link to Forms on right column of this webpage). These provincial forms are to be used by patients and practitioners from this point forward. (The forms should be downloaded from this website each time they are required, to ensure the most recent version is used.)
The set of forms includes the patient request form (for a patient to submit their request for medical assistance in dying), the assessor form (for an assessing practitioner to record details of a patient’s eligibility assessment) and the prescriber forms (for a prescribing practitioner to record details of a patient’s eligibility assessment and details related to the planning, administering and reporting of medical assistance in dying).
The completion of these provincial forms meets the requirements of the professional regulatory colleges (Physicians and Surgeons, Registered Nurses and Nurse Practitioners, and Pharmacists), the BC Coroners Service and the BC Vital Statistics Agency, regarding the completion of documentation and reporting on medical assistance in dying.
Where are the forms to be submitted?
The patient can submit their request form directly to their medical or nurse practitioner or can contact a health authority’s care coordination service for medical assistance in dying (see health authority links below).
The prescribing medical or nurse practitioner is responsible for submitting all provincial forms for medical assistance in dying (MAiD) to the British Columbia Coroners Service (including the new BC Coroners Service Report of MAiD Death form, and the Vital Statistics Agency Medical Certification of Death form). Details on submitting forms to the BC Coroners Service and to the health authority (for health authority involved cases) are located on the Document Submission Checklist form and at the top of each individual form.
What is the process for prescribing drugs used in medical assistance in dying?
Physicians, nurse practitioners and pharmacists must follow the standards set out by their respective professional college when writing a prescription or dispensing drugs for medical assistance in dying. There is an expectation that the British Columbia standardized drug protocols and prescription form will be used.
The British Columbia Pharmacy Protocols guidance document and the British Columbia Medical Assistance in Dying Prescription form (includes the pre-printed order, planning and accountability sections, and medication administration record) are not available for general distribution. The prescribing physician or nurse practitioner can access these documents by contacting the health authority care coordination service for medical assistance in dying, or the College of Physicians and Surgeons. Pharmacists may also familiarize themselves with the standardized drug protocols by accessing the British Columbia Pharmacy Protocols guidance document through the secure portion of the College of Pharmacists website.
When drugs need to be purchased from a community pharmacy, in order for patients to get 100% coverage, the prescriber must:
- Complete the Application for PharmaCare Medication Coverage for Medical Assistance in Dying form.
- Fax the form to the Ministry of Health PharmaCare Special Authority branch at 1 800 609-4884, along with the following completed sections of the BC Medical Assistance in Dying Prescription form:
- Identification and Declaration section;
- Intravenous Drug Protocol section; and
- Oral Drug Protocol section.
Please note that:
- The form should not be sent to a health authority or the BC Coroners Service.
- The special authority form should be submitted as soon as possible to ensure approval before the drugs are required.
- The special authority is approved for a period of 60 days, which can be extended upon request.
When drugs and supplies are dispensed from a health authority pharmacy, they are fully covered by the health authority.
More information on the expectations related to the prescription process is available in the standards of the College of Physicians and Surgeons, the standards, limits and conditions of the College of Pharmacists of British Columbia, and the standards, limits and conditions of the College of Registered Nurses of British Columbia.
How do I fill out the death certificate after providing medical assistance in dying?
In order to meet the requirement that medical assistance in dying is indicated on the Medical Certification of Death and that the cause of death is the underlying illness or disease causing the grievous and irremediable medical condition, the Vital Statistics Agency recommends that the Medical Certification of Death be completed as follows:
- Report medical assistance in dying in PART 1 (a);
- Report the underlying illness/disease causing the grievous and irremediable medical condition in PART I (b); and
- Report manner of death as "natural."
Who should I contact with questions about medical assistance in dying policy and processes?
Health-care providers working within health authorities should contact their health authority’s designated co-ordinator for medical assistance in dying, or their supervisor for more information on policy and processes. Health authorities play a central role in coordination of medical assistance in dying services and are prepared to support patients and care providers who need assistance in navigating the service.
Health-care providers not affiliated with a health authority should contact their provincial regulatory college for information on medical assistance in dying processes.
Standards and Guidelines
The provincial regulatory colleges have laid out medical assistance in dying standards and guidelines so registrants know what is expected of them when they are approached about or are participating in providing the service: