VSED as an Alternative to MAiD: A Pan-Canadian Legal Analysis

Abstract

Voluntary Stopping Eating and Drinking (VSED) is an alternative to Medical Assistance in Dying (MAiD) for patients who want to hasten their death but do not either want, or do not have, the option of MAiD. VSED for the purposes of this paper is: 1) a patient with capacity electing to stop eating and drinking as a means of hastening their death with or without physician support; or 2) a previously capable patient refusing oral and artificial nutrition and hydration through an advance directive. This paper looks at the legal status of VSED across the country and whether a competent person can cause his or her own death through VSED and secondly, whether health care providers must respect a previously competent person’s prior capable expressed wishes regarding VSED. Competent individuals are legally permitted to refuse oral and artificial nutrition and hydration in all provinces and territories across Canada. Previously competent persons are legally permitted to refuse artificial nutrition and hydration through a valid advance directive in all provinces and territories across Canada. Previously competent individuals can refuse oral nutrition and hydration through a valid advance directive in Newfoundland and Labrador, Nova Scotia, Prince Edward Island, Quebec, Ontario, Alberta, British Columbia, Yukon and Nunavut. In New Brunswick, Manitoba, Saskatchewan and the Northwest Territories the legal status of VSED for a previously competent person refusing oral hydration and nutrition through an advance directive is less certain. Therefore, VSED is a legal alternative to MAiD for many individuals in Canada.