It is June 17, 2016 and Bill C-14 is passed to legalize Medical Assistance in Dying (MAID).
 To ensure access to care for patients in our community, it is important for NBRHC to develop a process and policy to offer this
service within the scope of legislation.
BACKGROUND:
 With the passing of Bill C-14 in June 2016, patients now had the right to request medical assistance in dying from their physician or nurse practitioner.
 The legislation identified eligibility requirements for patients to receive MAID and also outlined the safeguards that physicians and nurse practitioners must follow to legally provide MAID.
 Position statements on MAID were published by regulatory bodies (College of Physicians and Surgeons of Ontario, College of Nurses of Ontario and Ontario College of Pharmacists). These documents were published to help health care providers understand their roles and responsibilities in the MAID process, and also to highlight the rights of health care providers to conscientiously object to participate in assisted dying.
 Health care providers across the country acknowledged their personal uncertainties surrounding MAID and identified a need for more education, knowledge and skill development.
Preliminary Discussions about MAID at NBRHC
 Before a process and policy could be drafted at NBRHC, it was necessary to engage the stakeholders and begin discussing MAID. An interdisciplinary working group was formed to lead these discussions with key stakeholder groups:
o Several physician groups, with a focus on General and Family Practice
o Chaplaincy Services
o Clinical Managers
o Medical Advisory Committee (MAC)
o Nursing Practice Advisory Committee (NPAC)
o Interprofessional Advisory Committee (IPAC)
o Ethics Committee
o Quality Committee of the Board
 Every stakeholder group had concerns and worries about implementing this procedure at NBRHC, mostly as a result of their uncertainties about this new option for end of life care.
 Ethics was a common topic of discussion among all groups and it was important to assure individuals that our draft policy would take their concerns into consideration. A consultation with the ethicist occurred.
 Later discussions with the clinical stakeholders involved exploring the practical aspects of MAID such as documentation requirements, drug regimens, location of the procedure, number of physicians willing to provide the service, appropriate staffing on the day of the procedure and education support for physicians, nurses and pharmacists. You are your team will be making a presentation to the Quality committee of the board. Your goal is to provide a background on MAiD and to reassure the board that you have covered the bases and dealt with the issues. As part of the presentation, please cover these issues and any other items you have encountered.
What are the potential challenges to implementation? What steps would you take to develop a policy for MAID? Who would you involve? What research would you do? How will you know if the policy and process is working well? What will you do to make sure NBRHC is ready to serve? How will you respond to media inquiries? What other processes will have to be looked at? Given the sensitivities around this issue, how might we celebrate those that have worked on the process and policy?