Thank you for inviting me here today.
My name is Julie Campbell. I'm a nurse practitioner and the vice-president of the Canadian Association of MAiD Assessors and Providers, or CAMAP. CAMAP represents professionals who work in the delivery of MAID in Canada. CAMAP does not take a position on MAID MD-SUMC. We are focused on, and committed to, supporting our members to provide the highest standard of medical care within the law.
As part of this commitment, CAMAP has, over the past two and a half years, developed the Canadian MAID curriculum, or CMC, the first comprehensive, nationally accredited, bilingual and evidence-based educational program to support the practice of MAID in Canada. It aims to educate new MAID practitioners, advance the skills of existing MAID practitioners, and help standardize the approach to care by supporting those who deliver MAID care from coast to coast. On August 21, 2023, the CMC was launched, and the enthusiastic response from clinicians exceeded expectations. Feedback from clinicians who have completed modules has indicated very positive responses when asked if they felt that their knowledge and confidence had increased.
In addition to expertise in MAID assessment and provision, CAMAP members also carry a variety of clinical expertise in many areas, including psychiatry. Our members rely on colleagues who act as consultants in their area of expertise. When an assessment is completed for a patient without a reasonably foreseeable natural death, and for whom neither assessor has both expertise in MAID and expertise in the condition causing the patient's suffering, we rely on these consultants to provide their expertise in the condition to add to the assessors' expertise in MAID assessment.
The difference between the role of assessor and the role of consultant is important to understand. Our psychiatrist colleagues have, by virtue of their extensive training and expertise as psychiatrists, advanced knowledge on capacity decisions and mental disorders. We have utilized their skills as consultants for any patient who requires it. This is not specific to patients with MD-SUMC, and it may apply to both patients with and without a reasonably foreseeable natural death. For patients with MD-SUMC, we will utilize their skills once again.
In Canada, there are approximately 5,000 psychiatrists who, by virtue of their education and skill, may act in the role of a consultant. Included in that, there are psychiatrists who have sought and obtained expertise in MAID assessment. To date, more than 100 psychiatrists have begun or completed training with the CMC, demonstrating a significant level of interest of this subset of psychiatrists, who will then both be a source of expertise from their respective backgrounds and have expertise as assessors.
Since 2016, we have safely assessed patients requesting MAID who also had comorbid mental disorders. Part of our thorough, thoughtful, and safe approach to eligibility assessment has always been to see the patient as a whole. To help our members, we have developed clinical guidance documents such as “Assessment for Capacity to give Informed Consent for Medical Assistance in Dying (MAiD)” and “Medical Assistance in Dying (MAiD) Assessments for People with Complex Chronic Conditions”. These documents have helped guide our members to safely assess and provide for patients with complexities. They have helped us develop experience that will be relevant to assessing patients with requests for MAID MD-SUMC.
As is standard in medical practice, we are evolving each day, sharing our best practices and gaining experience, and we now have almost seven years of experience upon which to draw. We have organized and facilitated knowledge exchange workshops with representatives from across Canada. One knowledge exchange was focused on clinician readiness, and the other on system readiness, to ensure not only that the clinicians are ready, but that the other important members of our teams are also ready—namely, nurses, social workers and administrators, among others. We have hosted a three-part fall symposium with specific learning around assessing individuals with mental disorders. We hold monthly case-sharing webinars. We have prepared diligently for the expiration of the sunset clause, and we are ready.
CAMAP members are ready for the planned legislative change in March 2024 and will continue to provide compassionate and high-quality care to all patients considering MAID.
Thank you.