*Please note, this glossary contains words and terms that are definitions which have been compiled from various sources. I practice in British Columbia, Canada andthe majority of information here comes from Canadian sites. This list is for information purposes only and, as with any information or advice, you are encouraged to seek the guidance and instruction of your trusted professionals – your doctor, lawyer, etc. – before making decisions or completing legally binding documentation.
A
Advance Care Plan (ACP): A generic term for the umbrella of planning documents in which you think about and express your wishes for future health care and treatment in circumstances where you can’t speak for yourself. An ACP may include an advance directive, or a representation agreement, in which the capable adult names another person to make health care decisions on behalf of the adult. This other person is called a medical representative.
Advance Care Planning: Advance care planning is the process a capable adult follows to ensure that their beliefs, values, and wishes for future health care are known in the event that the adult is incapable of making health care decisions when the health care is required.
Advance Directive: An advance directive is a capable adult's written instructions expressed directly to their health care provider, and shared with their representative if they have named one in a representation agreement, for the medical or non-medical care the adult consents to or refuses in the event they are incapable when the care is needed. Advance directives are legally binding documents that are intended to ensure your end-of-life wishes are respected in the event that you become unable to make decisions for yourself. The name of the document may be different depending on where you live.
AND: Acronym for “Allow Natural Death.”
Assisted Death: Called different things in different countries – physician-assisted death, aid in dying, assisted euthanasia – and known as Medical Assistance in Dying (MAiD) in Canada.
Autonomy: The choice among alternatives, based on one’s values, beliefs, and hopes.
*An important note on the difference between an Advance Directive and an Advance Care Plan: An advance directive is a legally binding document that provides the adult’s written instructions, made while capable, directly to their health care provider, for the health care they wish to consent to or refuse when incapable. An advance care plan may include a representation agreement and/or an advance directive, both of which are optional. An advance care plan that does not include a representation agreement or an advance directive informs the person chosen by a health care provider to make health care decisions for the adult of the adult’s instructions or wishes expressed while capable. That person is called a temporary substitute decision maker. (Source: gov.bc.ca)
B
Bereavement: The state of having lost a loved one.
Bill C-7: Bill C-7 received Royal Assent on March 17, 2021. It was an act to amend the Criminal Code (medical assistance in dying) and most notably expanded eligibility to permit MAiD for people whose natural death is not reasonably foreseeable.
Bill C-14: Bill C-14 received Royal Assent on June 17, 2016. It formally legalized assisted dying in Canada and laid out rules for how it could be accessed.
Brain Death: Irreversible cessation of brain activity.
C
Capacity: A person’s assessed ability to a make a decision. In a medical context, capacity refers to the ability to utilize information about an illness and proposed treatment options to make a choice that is congruent with one’s own values and preferences.
Cardiopulmonary Resuscitation (CPR): A medical term that means applying pressure to the chest, or an electric charge to re-start the heart, and sending air directly into the lungs to assist in breathing.
Casualty: A death resulting from a disaster or accident. (also: Fatality)
Chosen Family: Non-biological bonds, whether legally recognized or not, deliberately chosen for the purpose of mutual support and love.
Coma: A profound or deep state of unconsciousness. A person in a coma is alive but not able to move or respond to the environment around them.
Comfort Care: Care which focuses on managing pain and providing comfort. Often associated with end-of-life or hospice care but may be applied alongside curative treatments as well.
Condolences: Expressions of sympathy.
Conscientious Objection: When a health care provider does not wish to provide or participate in a legal and clinically appropriate treatment or procedure because it conflicts with their personal beliefs or values.
Continuum of Care: The course of therapy which addresses comfort care and symptom relief; a common phrase in hospice care as relates to end-of-life pain management.
D
Dead on Arrival (DOA): Pronounced dead upon arrival, generally at a hospital.
Death Café: A group discussion about death and dying, with no agenda, objective, or theme. It is a discussion group rather than a grief support or counselling session, however the environment is supportive to sharing difficult experiences and exploring curiosities.
Death Doula/End-of-Life Doula: A death doula, also commonly known as an end-of-life doula, is a non-medical person trained to care for someone holistically (physically, emotionally and spiritually) at the end of life.
Death with Dignity: A term or expression used when someone’s death is aligned with their values, and generally peaceful without much suffering. In the U.S., it is also the name of an advocacy organization.
Decease/Deceased: Legal or formal term for death.
Demise: The end of something or death of a person.
Do Not Intubate (DNI): A physician’s order on a person’s medical file, as per the patient’s directive, meaning no breathing tube will be used in the case of respiratory arrest or breathing difficulties. A patient may change the directive at any time.
Do Not Resuscitate (DNR): A physician’s order on a person’s medical file, as per the patient’s request, meaning neither cardio-pulmonary resuscitation (CPR) nor electric shock will be used to restart the heart in the case of cardiac arrest. A request for a formal DNR order varies by province or territory. A patient may change the directive at any time.
Dying With Dignity: In Canada, Dying With Dignity Canada (DWDC) is the national human-rights charity committed to improving quality of dying, protecting end-of-life rights, and helping people across the country avoid unwanted suffering.
E
End-Stage: The final stage of a disease that cannot be cured and will lead to death.
Euthanasia: Act of causing a painless death to end suffering. There are many terms used around the globe for medical assistance in dying – the term we use in Canada. Terms vary in jurisdictions with assisted dying laws. (see also: Medical Assistance in Dying)
Expiration/Expire: To die; literally "to breathe out" for the last time.
F
Fatality: A death resulting from a disaster or accident. (also: Casualty)
Forced transfer: The term used when a patient is made to move locations for an assisted death because the facility they are in forbids or restricts medical assistance in dying.
G
Grave: The resting place of one’s body, commonly in a casket and underground.
Grievous and Irremediable: In Canada, to have a grievous and irremediable medical condition, a person must have a serious illness, disease, or disability, be in an advanced state of decline that cannot be reversed, and experience unbearable physical or mental suffering from an illness, disease, disability, or state of decline that cannot be relieved under conditions that the person considers acceptable.
H
Heart failure: A condition where the heart is damaged and fails to pump enough blood to the critical organs in your body.
Hospice: An organization, institution, or facility that provides comfort care for a person when medical treatment is no longer expected to cure the disease or prolong life. Hospice care may also be provided in an at-home setting.
I
ICE: Acronym for “In Case of Emergency”; used to denote your contact person, generally on your phone or other important documents.
Independent Witness: An individual who confirms the signing and dating of legal documents (eg. Will, POA, Medical Representation Agreements, MAiD requests). They must be the age of majority and not benefit from the person’s death in any way.
Informed Consent: The voluntary decision a patient makes after understanding treatment options, risks, and benefits.
Inquest: Official investigation into a death, usually by a Coroner.
Intensive Care Unit (ICU): Sometimes referred to as the Critical Care Unit, the ICU is a hospital ward with highly specialized staff. It is for the patient with a life-threatening illness or injury, including major surgery with a threat of complications, who requires constant monitoring and the support of specialized equipment.
Intravenous: To give medication or fluids through the vein.
J
K
L
Life-Sustaining Treatment: Treatment that replaces or supports bodily functions that are not working. It may be used temporarily for a treatable condition until the patient is stabilized. When there is no hope of the body regaining the ability to function normally, life support may simply prolong the dying process without the benefit of increased quality of life and the medical representative or next of kin may be asked if such treatment should be stopped, either as outlined in legal documentation or as the patient would have wanted.
Living Will: A US term that has crept into Canadian language through movies and media. More commonly called an Advance Directive in Canada, and is often interchanged with Advance Care Planning. (Please see these terms above for further clarification)
Lost/Loss: Refers to the death of someone; often used in discussions of grief.
M
Mature Minor: In Canada, the mature minor doctrine allows children who are sufficiently mature to make their own treatment decisions. Age of maturity varies by province and territory.
Mechanical breathing: Used to support or replace the function of the lungs. A ventilator or respirator is a machine attached to a tube which is inserted into the patient’s nose or mouth and down into the windpipe in order to force air into the lungs. It helps people with a short-term medical problem. People with irreversible respiratory failure such as that caused by injury to the spinal cord or a progressive neurological disease will require long term ventilation; in such cases, the tube is inserted through a small hole at the front of the throat into the trachea (tracheostomy tube).
Medical Assistance in Dying (MAiD): The term used in Canada; medical assistance in dying occurs when, after you have met the eligibility criteria and with your consent, a nurse practitioner or physician provides or administers medication that intentionally causes death. (Please visit your province’s resources, Canadian government resources, Canadian Association of MAiD Assessors and Providers (CAMAP) https://camapcanada.ca/ or Dying With Dignity https://www.dyingwithdignity.ca/ for more information and specific legislation).
Medical Representation Agreement: Sometimes called a Power of Attorney for Personal Care; a legal document appointing a person who can speak for you should you be incapacitated.
Memento Mori: An object serving as a warning or reminder of death. A Latin phrase which translates to "remember that you [must] die"; often an artistic or symbolic reminder—such as a skull, hourglass, or wilting flower—of the inevitability of death and the temporary and fleeting nature of human life. The practice seeks to encourage focusing on mortality to live more intentionally and value the present.
Moribund: At the point of death.
Mortality: The state of being subject to death. Also, death on a large scale.
N
Necrosis: Death of body tissue.
Neurocognitive Medical Condition: A general term that describes decreased mental function due to a medical disease (other than a psychiatric illness). This includes conditions such as dementia, Huntington’s and Parkinson’s.
Nurse Practitioner (NP): Registered nurses who have additional education and nursing experience which enables them to autonomously diagnose and treat illnesses, order and interpret tests, prescribe medications, perform medical procedures and provide MAiD in Canada.
O
Obituary: A notice of death, traditionally in a newspaper but often found online now.
P
Pain: One of the most often expressed worries by those on the end-of-life journey. “Total pain is the suffering that encompasses all of a person’s physical, psychological, social, spiritual, and practical struggles.” Dame Cicely Saunders
Palliative Care: Palliative care aims to relieve suffering and improve the quality of life for those living with a life-limiting illness. Hospice palliative care addresses the specific physical, psychological, social, spiritual, and practical issues, and their associated expectations, needs, hopes and fears on an individual basis2. Most often this care is provided in a hospital or hospice setting but can be provided at home, and may be given in conjunction with medical treatment such as chemotherapy or radiation.
Passing/Passing On/Passing Away: A common euphemistic alternative to "death"; often considered a more gentle way to describe the act of dying.
Power of Attorney (POA): A document which designates someone who is legally appointed to speak on your behalf if you lose capacity. There are many terms for this document, even across Canada, but a POA generally refers to legal and financial authority, whereas a Power of Attorney for Personal Care (confusing, right?) or Medical Representation (Rep 9 here in BC) gives your designate(s) authority to follow your medical wishes or, in the absence of your having left any such directive, make decisions on your behalf.
Q
R
Reasonably Foreseeable Death: Natural death has become “reasonably foreseeable” meaning that, in the professional opinion of the medical team, taking into account a combination of the patient’s known illnesses and physical frailties (age-related and otherwise), how or when the patient’s natural death will occur is reasonably predictable.
Requiem: A mass for the dead.
(At) Rest: Implies a tranquil death.
S
Self-Administered Death: In Canada, a physician or nurse practitioner can give or prescribe to a patient a substance that they can self-administer to cause their own death. Terms vary in jurisdictions with assisted dying laws. (see CAMAP https://camapcanada.ca/ for more information)
Stroke: Damage to the brain caused by a blockage of blood flow, or bleeding into the brain. The degree of disability resulting depends on the location and severity of the initial cause.
Substitute Decision-Maker: Someone you appoint to make decisions on your behalf if you lose capacity to make decisions about your own personal care and/or finances. Terms and responsibilities differ across the provinces/territories.
Suicide: Death by suicide is death caused by injuring oneself with the intent to die.
Support Person: Someone who assists a patient in navigating the health care system. This is not a legal role, nor is it the same as a Substitute Decision-Maker, although a Substitute Decision-Maker may also act as a support person.
T
Terminal Illness: A medical condition which cannot be cured and which is expected to lead to death within weeks or months.
(Death) Throes: The final struggles before death that some people experience.
Track 1: If you are assessed for MAiD (in Canada) as a Track 1 patient, it means your death is reasonably foreseeable. Safeguards differ for Tracks 1 and 2.
Track 2: If you are assessed for MAiD (in Canada) as a Track 2 patient, it means your death is not reasonably foreseeable. Safeguards differ for Tracks 1 and 2.
Tomb: The resting place.
U
V
Voluntary Stopping of Care (VSC): People who wish to allow their life to end naturally sometimes refuse or discontinue care including health care to prevent or cure illness. This may be referred to as voluntary stopping of care (VSC) or voluntary stopping of personal care (VSPeC).
Voluntary Stopping of Eating or Drinking (VSED): Refusal or stopping of oral or tube-delivered nutrition or hydration.
W
Waiver of Final Consent: A document that allows someone who has already been assessed and approved for MAID in Track 1 to receive it on or before their chosen date even if they do not have the capacity to consent at the time of the MAID procedure. It is a written agreement signed between a Track 1 patient and their MAID provider.