I appreciate both of the previous speakers. Thank you.
My name is Dr. Stefanie Green. I'm a family physician with over 30 years of clinical experience, and I've been a MAID practitioner in British Columbia since June 2016. I'm here today with Dr. Gordon Gubitz, a neurologist based in Nova Scotia, who has also been a MAID practitioner since law allowed. We have both been deeply involved in MAID training, oversight, teaching, research, and curriculum and guideline development at the local, national and international levels.
We're here today as representatives of the Canadian Association of MAID Assessors and Providers, a national professional organization that I co-founded and have helped lead for nearly a decade. CAMAP is the community of diverse professionals involved in administering and delivering assisted dying across Canada. It supports MAID professionals in their work, educates the health care community about MAID and provides leadership on determining standards and guidelines of practice within the laws of the country, all of which supports our patients, their families and hopefully one another.
I'd like to emphasize that CAMAP does not advocate for change in law. We have no role in determining what the laws of this country do or do not permit. Rather, we recognize that this is the role of Parliament. We empathize with the challenging task facing this committee, and we are pleased to be able to offer insights from our 10 years of experience.
One of CAMAP's contributions to MAID practice is the Canadian MAID curriculum. This project began when CAMAP was approached by parliamentarians to lead this initiative, and it was funded through a grant obtained from Health Canada. A peer-reviewed publication describing the extensive development framework and the robust editorial review process that was undertaken has been submitted to you for your information.
The result is a rigorously developed, comprehensive, bilingual national program, fully accredited by the Royal College of Physicians and Surgeons of Canada, the College of Family Physicians of Canada and the Canadian Nurses Association. The accreditation process of these organizations is the mechanism through which continuing professional education is determined to have appropriate quality for doctors and nurses.
The curriculum requires a significant health care background in order to understand the content. Furthermore, early modules are a foundation for later, more specialized content. This explains why, despite being asked to supply this committee with a copy of the module on MAID and mental disorders, we sent you a package outlining the entire curriculum so that you can view it in its context.
This committee's mandate is to undertake a comprehensive review relating to the eligibility of persons whose sole underlying medical condition is a mental illness to receive MAID. Part of that assessment has been to try to determine clinician and system readiness. We can attest to clinical readiness. Medical and nursing practitioners in this country are well trained and competent in assessing a patient's decision-making capacity, the voluntariness of their requests, and suicidality. These skills are, in fact, utilized every day and with every patient encounter. Professionals who have taken the Canadian MAID curriculum have further expanded and deepened their knowledge and skill set.
For the past 10 years, MAID practitioners have assessed patients with comorbid mental illness. We already have a decade of experience assessing if the mental state of an individual interferes with their decision-making capacity, if the request is truly voluntary or if they're suicidal.
When a 63-year-old woman with pancreatic cancer came to see me a few years ago for an assessment of eligibility for MAID, we also needed to discuss her lifelong bipolar disorder, the hospitalizations it required, the successful and failed treatments through the years and her history of suicidal ideation. The law required that I form a medical opinion as to whether her request for MAID was being influenced by her mental disorder, whether it was voluntary and whether or not she was suicidal. I used my training as a family physician and the extra training from CAMAP and was grateful for the input of her treating psychiatrist.
This work is doable. Also, yes, some patients may be even more complex, but as my daughter recently reminded me, some things are hard, but you can still do them.
Further readiness is evidenced by CAMAP's release of national guidance documents on assessing capacity, assessing incurability, and the approach to people with complex chronic conditions. The nationally developed model practice standard for MAID has contributed to the understanding of regulatory standards, and the Canadian Psychiatric Association has just released further guidance on evaluating eligibility criteria in persons with mental disorders and on the management of suicide risk. All of this is to say that the clinicians who are willing and interested in doing this work are ready.
Dr. Gubitz is in the room with you and will be happy to take the majority of your questions.
Thank you for your attention.