Medical Assistance in Dying: Challenges of Monitoring the Canadian Program
Open accessAbstract
The Canadian medical assistance in dying (MAID) program, based on an ambitious piece of legislation and detailed regulations, has failed to provide Canadians with sufficient publicly accessible evidence to show that it is operating as mandated by the requirements of the law, regulations, and expectations of all stakeholders. The federal law that was adopted in 2016 defined the eligibility criteria and put in place a number of safeguards that had to be satisfied before providing assisted dying to a person in order not to transgress the Criminal Law. The responsibility of monitoring for the purpose of investigating compliance with the eligibility criteria and procedural safeguards was assigned by the Federal Ministry of Health (responsible for all monitoring) to the provincial and territorial governments. Some of the governments have released statistical data concerning the program, but none have yet issued a comprehensive report on adherence to the eligibility criteria and its safeguards as required by the law and regulations. This paper explains the process, explores the possible reasons for this shortfall, and offers some suggestions for actions that could rectify this aspect of the MAID program. Accountability and transparency are integral to the delivery of MAID and the publications of the mandated federal as well as provincial/territorial monitoring reports are one important approach to achieving confidence and trust in the program.
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An independent review article determined that monitoring of MAiD is grossly deficient.
“An independent review article determined that monitoring of MAiD is grossly deficient (Kotalik 2020).”
From The realities of Medical Assistance in Dying in Canada (2023) · cites this paper as Kotalik 2020
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Cites
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Research works printed but not linked: 2
- Parliament of Canada. Bill C-14. Statues of Canada 2016. Chapter 3. Assented to June 17, 2016.
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The realities of Medical Assistance in Dying in Canada
Coelho, R., Maher, J., Gaind, K. S., & Lemmens, T. (2023) · Palliative and Supportive Care · doi:10.1017/s1478951523001025 · Cited by 70 · see citing works
“Anindependentreviewarticle determinedthatmonitoringofMAiDisgrosslydeficient(Kotalik 2020).”
Pullman, D. (2023) · The American Journal of Bioethics · doi:10.1080/15265161.2023.2201190 · Cited by 55 · see citing works
Canadian Medical Assistance in Dying and the Hegemony of Privilege
Kim, S. Y. H. (2023) · The American Journal of Bioethics · doi:10.1080/15265161.2023.2264096 · Cited by 11 · see citing works
Comparison of official reporting on assisted suicide and euthanasia across jurisdictions
Worthington, A., Regnard, C., Sleeman, K. E., & Finlay, I. (2024) · BMJ Supportive & Palliative Care · doi:10.1136/spcare-2022-003944 · Cited by 10 · see citing works
Canada’s Medical Assistance in Dying System can Enable Healthcare Serial Killing
Lyon, C. (2024) · HEC Forum · doi:10.1007/s10730-024-09528-3 · Cited by 7 · see citing works
Palliative Care and Medical Assistance in Dying
Herx, L., & Kaya, E. (2023) · The International Library of Bioethics · doi:10.1007/978-3-031-30002-8_12 · Cited by 4 · see citing works
Close, E., Downie, J., & White, B. P. (2025) · Death Studies · doi:10.1080/07481187.2025.2572743 · Cited by 1 · see citing works
Federal Annual Reports on MAID: Informative but Incomplete Picture
Kotalik, J. (2023) · The International Library of Bioethics · doi:10.1007/978-3-031-30002-8_8 · Cited by 1 · see citing works
Self-citationKotalik, J., & Pedri, L. (2023) · The International Library of Bioethics · doi:10.1007/978-3-031-30002-8_29
Self-citation
- Authors
- Kotalik, J.
- Affiliations
- Lakehead University (CA)
- Corresponding author
- Kotalik, Jaro
- Venue
- Canadian Journal of Bioethics
- Publisher
- Consortium Erudit
- Published
- 2020-12-01
- Volume
- 3
- Issue
- 3
- Pages
- 202-209
- ISSN
- 2561-4665 (ISSN-L)
- OpenAlex
- W3110774643
- Cited by
- 9
- References
- 5
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 6 · 2022: 1
- FWCI
- 1.31
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Canadian Journal of Bioethics (publishedVersion, cc-by)
- Érudit (Université de Montréal) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Keywords
- medical assistance in dying, assisted dying, program monitoring, procedural guarantees, accountability, transparency, federal-provincial relations
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