What is medical assistance in dying (MAID) in Canada?

Medical assistance in dying (MAID) is the federal legal regime that allows eligible adults in Canada to receive medical assistance in ending their lives. The regime was created by Bill C-14, which received Royal Assent on June 17, 2016 in response to the Supreme Court of Canada's decision in Carter v. Canada (Attorney General) (2015), and expanded by Bill C-7, which received Royal Assent on March 17, 2021. MAID is governed by sections 241.1 to 241.31 of the federal Criminal Code and administered by provincial healthcare systems and regulated health professionals.

Eligibility for MAID requires that the person be at least 18 years old, be eligible for publicly funded health services in Canada, have made a voluntary request that was not made as a result of external pressure, and give informed consent after being informed of available means to relieve suffering. The person must have a grievous and irremediable medical condition, defined as a serious and incurable illness, disease or disability, an advanced state of irreversible decline in capability, and enduring physical or psychological suffering that is intolerable to the person and that cannot be relieved under conditions the person considers acceptable.

Bill C-7 of 2021 made several major changes. The reasonably-foreseeable-death requirement (which had been struck down in Truchon v. Canada, 2019) was removed, allowing MAID for persons whose natural death was not reasonably foreseeable, with additional safeguards. Two MAID tracks now operate: Track 1 (reasonably foreseeable death, 10-day reflection period waivable, two independent witnesses) and Track 2 (death not reasonably foreseeable, 90-day assessment period, expert assessor in the relevant condition required). MAID for mental illness as the sole underlying medical condition is currently deferred until March 17, 2027 by Bill C-62 of 2024.

MAID is delivered in Canada in growing numbers. Health Canada's annual MAID reports show that MAID accounted for about 4.7 per cent of all deaths in Canada in 2023 (about 19,660 of 411,000 deaths). About 96 per cent of MAID deaths in 2023 were Track 1 (reasonably foreseeable death). Cancer was the most common underlying condition (about 64 per cent), followed by cardiovascular conditions, chronic respiratory conditions, and neurological conditions. Most MAID provisions are delivered by physicians and nurse practitioners. Federal-provincial monitoring continues through the Canadian MAID Data Collection Portal and provincial review committees. Advance requests for MAID, allowing consent before loss of capacity, remain a topic of active federal-provincial debate (Quebec passed enabling legislation in 2023).