Question Period Note: MEDICAL ASSISTANCE IN DYING (MAID)

• Our Government places the highest priority on ensuring Veterans and their families have the support and services they need, when and where they need it.

• We deeply regret what transpired and have taken this issue very seriously. We understand the significance of the situation and appropriate actions are in place to ensure this situation does not happen again.

• Following a thorough review, VAC has concluded that there were four (4) isolated incidents related to one (1) employee and it is not indicative of a wider pattern of behavior or a systemic issue.

• If a Veteran is seeking advice or assistance with MAID, employees are trained to refer the Veteran to their primary care provider.

• Employees receive mandatory training for situations involving Veterans who may be in crisis, as well as specific training regarding Medical Assistance in Dying.

BACKGROUND — MEDICAL ASSISTANCE IN DYING (MAID

The Department was made aware in August of 2022 of an incident involving a Veteran client and a Veterans Affairs Canada (VAC) employee where Medical Assistance in Dying was discussed inappropriately. The Veteran client called VAC to share what happened on the call with the VAC employee, at which time we immediately took action to address the situation and apologized to the client.

The department completed a thorough internal investigation. The investigation included a review of 402,000 unique client files dating back to 2016 across our three systems. The Department confirmed four cases. The findings indicate that this is not a widespread or systemic issue and was isolated to a single VAC employee, who is no longer employed at Veterans Affairs Canada.

Considerations for Medical Assistance in Dying (MAID) are the subject of discussions between a patient and their primary care providers to determine appropriateness in each individual context. It is covered through the provincial and territorial health authorities and is administered by a physician or nurse practitioner directly to the individual. Dying with Dignity website Get the facts on MAID | Dying With Dignity Canada (https://www.dyingwithdignity.ca/end-of-life-support/get-the-facts-on-maid/) can provide more information.

Medical Assistance in Dying is not a VAC service and is not within our scope of work.

However, we may be approached by Veterans following their decision to pursue Medical Assistance in Dying. In those cases, our employees can help the Veteran and the family understand their benefits, as well as any other support or services that might be relevant in the Veteran’s circumstances. Our employees are also trained to serve and assist Veterans who may be in crisis situations and ensure they have access to the support they need when and where they need it.

Guidance around Medical Assistance in Dying has been in place for all of our employees since Medical Assistance in Dying was legalized. Reminders about this, and other important items for our staff, are shared regularly. In light of these unfortunate incidents, we have and continue to communicate specifically about Medical Assistance in Dying with all of our client facing management and staff. All of our frontline staff were provided with mandatory training to reinforce the expectations and the available programs and services offered by the Department to support the health and well-being of Veterans.

WHEN PRESSED:

Q1 – How is medical assistance in dying (MAID) administered or approved?

Medical Assistance in Dying (MAID) is a deeply complex and personal medical issue that is out of the jurisdiction of Veterans Affairs Canada staff. For more information, please consult this link: Directive: Role of the Veteran Service Team (VST) Regarding Medical Assistance in Dying (MAID) - VS Toolbox - VAC@work (vac-acc.gc.ca) (http://intranet.vac-acc.gc.ca/eng/operations/vs-toolbox/directives/directive/3970)

Q2 – What is the role of VAC employees when it comes to Veterans requesting
medical assistance in dying?

If a Veteran is seeking advice or assistance with Medical Assistance in Dying, employees are trained to refer the Veteran to their primary care provider. If a Veteran has chosen to pursue Medical Assistance in Dying with their primary care provider and shares this information with a member of the Veteran Service Team (VST), VAC employees can support the Veteran in navigating VAC benefits and services available. Support can include resource coordination and navigation such as connecting a Veteran and their family to community resources, mental health practitioners, grief counsellors, pastoral outreach or other local resources.

Q3 – What steps and remedial action has VAC taken to address this issue?

The department understands the significance of the situation and appropriate actions were taken to ensure this situation does not happen again:
• A directive and training were provided to all frontline employees.
• Medical Assistance in Dying has been added as mandatory training for all current and new employees.
• Reassurance was provided to our clients who contacted us by phone, emails and online.
• At the direction of the Minister, the Department conducted a comprehensive investigation into this issue.
• We conducted a file review of 402,000 unique client files dating back to 2016 across our three systems.