Ontario's new care co-ordination service, launched in late May, was supposed to answer calls for Canada's most populous province to adopt the so-called Alberta model. Alberta's MAID system, which is generally regarded as one of the best in the country, has four care co-ordinators, all of them nurses, who act as central intake officers and arrange all aspects of the end-of-life procedure, including finding a doctor and two assessors, lining up the medications, scheduling the death and helping with the voluminous official paperwork. The approach has worked well for both MAID providers and for doctors who refuse on moral grounds to refer patients for assisted death – those conscientious objectors can give their patients contact information for the co-ordinating service and avoid a formal referral. But Ontario's new system is not a co-ordination service, according to James Downar, a critical- and palliative-care doctor at Toronto's University Health Network. In the Ontario system, a toll-free number operated by Telehealth Ontario between 9 a.m. and 5 p.m. on weekdays puts self-referring patients (or their caregivers) in touch with nurses who do the initial screening and connect them to a doctor or nurse practitioner on the registry. The toll-free line will be open 24 hours a day starting on Sept. 1.
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