How to support your clients

Supporting your clients during MAID

According to the Canadian Nurses Association, there are seven core values and responsibilities of a nurse during the time.
1. Providing safe, competent, compassionate and ethical care
– Nurses remain current on the state of the law and its implications for their professional practice.
– Nurses adhere to the jurisdictional roles and responsibilities of their nursing regulatory body
– Nurses aid in the provision of MAID with reasonable knowledge, care and skill and in accordance with any applicable provincial laws, rules or standards. 

2. Promoting health and well-being
– Nurses support persons in achieving their highest level of health in ways that are meaningful and acceptable to those persons.
– Nurses strive for excellence in end-of-life care options including palliative care and natural death or MAID. 

3. Respecting informed decision making
– Nurses recognize, respect and promote a capable person’s right to be informed and make decisions about their health and end-of-life care options including MAID.
– Nurses respect the wishes of capable persons who request information about MAID.
– Nurses do not impose their own views and values onto others nor use their position to influence, judge or discriminate against others whose values are different from their own.
– Nurses support a capable person’s right to withdraw their request for MAID at any time. 

4. Preserving Dignity
– Nurses work with the person inquiring about or requesting MAID, and with family members, groups and communities, in accordance with the person’s consent while respecting the person’s values, beliefs and decision.
– Nurses work to prevent or eliminate discrimination toward all those involved — persons, family members, health-care staff — in end-of-life care decisions and provisions, including MAID.
– Nurses listen actively to persons’ concerns, experiences and requests for information to identify opportunities for clarifying their goals of care, education needs, alterations in care and access to resources.
– Nurses foster comfort and support a dignified death.
– Nurses provide support for the family during and following the death.
– Nurses treat each other and all members of the health-care team respectfully, whether or not they choose to be involved in providing or aiding in MAID. 

5. Maintaining privacy and confidentiality
– Nurses respect the privacy of persons who inquire about or request MAID and protect the privacy and confidentiality of sensitive information about diagnosis and cause of death.
– Nurses adhere to current legislation, professional regulatory standards and employer policies regarding MAID, including IT security safeguards that protect and preserve the privacy of the person, as well as that of his or her family and the health-care professionals involved. 

6. Promoting justice
– Nurses contribute to the development of processes and practices that enable persons to access information on and request MAID.
– Nurses refrain from judging, labelling, demeaning, stigmatizing or humiliating persons who request MAID or who provide or aid in MAID (including each other), whether or not they have a conscientious objection to MAID.
– When a person requests MAID, nurses make fair decisions about the allocation of resources within their control based on the needs of the person.
– Nurses strive for sufficient resources that enable persons to access palliative care and MAID. 

7. Being accountable
– Nurses practice according to their code of ethics, in keeping with the laws, regulations, professional standards and guidelines for MAID in the jurisdiction where they practice.
– Nurses contribute to the development and evaluation of policies, guidelines and processes created for MAID.
– Nurses who anticipate a conscientious objection regarding MAID have an obligation to notify their employers so alternative arrangements can be made prior to care requests.
– Nurses who recognize a conscientious objection related to the provision of MAID must inform their employer or organization (either in accordance with this organization’s policy or with guidelines from the nursing regulatory body) and continue to provide safe, compassionate, competent and ethical care outside of MAID.
– When MAID has a psychosocial impact that is affecting their capacity to practice safely and competently, they must consult their employer, undertake steps to address any impact and seek support as needed. 

References:
Canadian Nurses Association. (2017). National Nursing Framework on Medical Assistance in Dying in Canada. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/cna-national-nursing-framework-on-maid.pdf