TORONTO – Nurse practitioners – not just doctors – would be allowed to provide medically assisted death to eligible patients under proposed legislation tabled Thursday by the federal government.
Their inclusion in Bill C-14 is being welcomed by both nursing and physician groups, which say that nurse practitioners are often the only medical professionals working in rural and remote communities who could provide patients with aid in dying.
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“This legislation shows a clear understanding and recognition of the nursing profession’s role in medical assistance in dying, both when nurses provide primary care, as in the case of nurse practitioners, and when they are part of an interdisciplinary health-care team,” the Canadian Nurses Association said in a statement.
Under the proposed legislation, physicians and nurse practitioners would be protected from Criminal Code prosecution for helping patients to end their lives, either through the prescribing of lethal drugs for self-administration or for euthanasia, in which the practitioner injects the fatal medications.
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Other health-care practitioners peripherally involved in assisted death, such as pharmacists, physician assistants, registered nurses and social workers, would also be protected from prosecution. The same is true for a family member who, for example, lifts a glass to a patient’s mouth to help them swallow the drugs.
Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, said the organization had pushed for the inclusion of nurse practitioners – registered nurses who have an additional two years of training that broadens their scope of practice.
“Nurse practitioners are primary-care providers for thousands of people in Ontario and, quite frankly, across the country,” said Grinspun.
He notes that the highly trained nurses care for patients in hospitals, primary-care settings, within the home and also in long-term care facilities.
In Ontario, nurse practitioners also have the legislative authority to admit, treat, transfer and discharge patients from hospital, she said.
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For the government to have restricted aid in dying only to doctors would have made “absolutely no sense,” she said. “You want the person who is the most close to you, the person who has been taking care of you all the time.”
Nurse practitioners are also licensed to prescribe medications. However, in Ontario, nurse practitioners currently can’t prescribe certain “protected substances,” which would include the powerful drugs needed to end a person’s life, said Grinspun.
The province and regulatory college need to move forward with regulations that would allow nurse practitioners to fulfil the mandate they’re given under the proposed federal legislation, she said.