As of June 6, 2016, medical practitioners and nurse practitioners in the Northwest Territories are allowed to provide medical assistance in dying.
Our priority is to protect both patients and health care providers involved in medical assistance in dying. Medical Assistance in Dying Interim Guidelines have been developed to ensure this service is provided in a safe, fair and consistent manner in the Northwest Territories.
A practitioner who has received a written request for medical assistance in dying, assessed a patient for eligibility, or provided medical assistance in dying will have reporting requirements under the Interim Guidelines and Criminal Code. Please see the Interim Guidelines and associated forms (below) for more information.
- Medical Assistance in Dying Interim Guidelines for the Northwest Territories – Effective November 1, 2018
- Medical Assistance in Dying Interim Medication Protocols for the Northwest Territories – Effective June 1, 2018
- Form 1 - Record of Patient Referral
- Form 2 - Formal Written Request by Patient
- Form 3 - Assessment of Patient by Practitioner
- Form 4 - Assessment of Patient by Consulting Practitioner
- Form 5 - Withdrawal Option
- Form 6 - Psychiatric Opinion
- Form 7 - Reflection Period Amendment—Practitioner
- Form 8 - Reflection Period Amendment—Consulting Practitioner
- Form 9 - Dispensing of Medication
- Form 10 - Express Consent by Patient
- Form 11 - Record of Provision
- Form 12 - Death of Patient from Other Cause
- Information Package for Health Care Providers
- Information Package for Patients and Families
- Central Coordinating Service Contact Information Card
- www.maidnwt.com / www.ammtno.com
If you have any questions about medical assistance in dying in the Northwest Territories, please contact: