Families of Canadians who received MAID talk of rushed assessment, not being told of decision: study
Rushed, incomplete assessments, families kept in the dark, loved ones driven to choose MAID because of unbearable suffering.
A new study adds to growing evidence that Canadian families’ experiences with doctor-assisted death are deeply mixed, with some describing the experience as raw, traumatic and surreal — including sometimes oddly “cheerful” providers — and others describing caring and compassionate deaths for loved ones who’d “had enough.”
Canada’s assisted-death law focuses on the rights and autonomy of people to choose when to end their lives.
But many families told the University of Alberta research team that families should be included in such profound, life-or-death decisions.
Some only learned of the MAID request after death, “raising the complex issue of patient autonomy versus family involvement,” the researchers wrote.
“I got a phone call on June 1st from her family doctor that I had never met. She said, ‘I’m sorry to inform you that your mother has passed away,'” one woman recounted. “And I literally told the doctor, I said, ‘No, no, no, you’ve got the wrong person, like, you’ve called the wrong person.'”
In December, 26-year-old Kiano Vafaeian, who struggled with vision loss from diabetes and depression, died by MAID in a Vancouver funeral home, despite being denied an assisted death multiple times in Ontario, his home province. When his mother was told her son was dead, she thought it was a prank.
In 2021, 61-year-old Alan Nichols, who had a history of depression, was euthanized over the objections of his family and nurse practitioner soon after being hospitalized for a psychiatric episode. The sole condition listed in his MAID application was hearing loss, The Associate Press reported.
“Canada is now noted as the fastest growing assisted dying program in the world,” the U of Alberta research team wrote.
As of the end of 2024, 76,475 MAID deaths had been reported in Canada since the practice was legalized in 2016. The country is expected to mark its 100,000th MAID death by summer.
A special joint parliamentary committee is now meeting to deliberate expanding MAID to those whose sole underlying condition is a mental illness, which is set to come into effect in March 2027.
The new, Health Canada-funded study asked families from five provinces — British Columbia, Alberta, Saskatchewan, Ontario and Quebec — to share their stories supporting 35 Canadians who received MAID. One-on-one virtual interviews were completed between October 2024 and January 2025.
Among the findings, in some cases the decision for MAID was driven by “unmanageable or unbearable symptoms” such as severe shortness of breath or pain so severe, “if you touched the bed, she was in agony,” as one family member described it.
Others feared loss of autonomy, and having to rely on others for daily tasks like bathing or toileting, or the possibility of moving into a nursing home.
“It was just like a series of losses, right,” one relative said. “You lose the ability to work. You lose the ability to play. You lose the ability to eat, to sleep, to do everything. So, the loss was already there…. The final, the MAID, was just like the grand finale of the loss journey.”
Some MAID deaths were driven by insufficient home care — “they come when they come but not when you need it,” one family member said — or drawn-out waits to see specialists.
“My mom needed psychiatric help,” reads one transcribed interview. “My mom was a victim of a broken healthcare system. My mom had been trying to see specialists for months and months and months (for a brain injury)…. It got to the point she lost all hope.
“And so my mom ended her life because of desperation, not anything to do with dignity.”
“Although many participants experienced respectful, caring and compassionate interactions with healthcare professionals involved in the MAID process, others did not, adding to already stressful and intense emotions,” the researchers wrote in BMC Palliative Care.
Some families described hasty assessments done over Zoom, without deep discussions about alternatives and supports families could offer to help, and “what felt like a rapid assessment-to-provision timeline, which contributed to concerns that MAID may have occurred prematurely.”
Canada’s law requires two assessors to agree a person is eligible for MAID. But some families said the second assessor seemed to simply “rubber stamp” the first assessor’s decision.
Concerned were raised about the accuracy of assessments, including whether mental health issues were fully addressed. A two-page list compiled by one family of their father’s history of depression, suicidality, personality traits and other suspected mental illnesses was largely ignored.
Several families described being ill-prepared for the day of the MAID provision. “I was somewhat traumatized. Not somewhat. I was,” one said.
“I was disturbed at how long the process took. Yeah, how long the process took. And it’s very raw. Your first injection, second injection, third, fourth. It goes on.”
Some participants described dispassionate care and a “cold, uncaring, unempathetic” MAID provider. “Booking our MAID date was like booking a dinner reservation. So, it’s just all very, very, very impersonal.”
What one family found most off-putting was that the MAID provider seemed strangely “cheerful about it.”
Other families said they struggled to find any willing provider. “It was an absolutely brutal contradiction of trying to fight for somebody to be able to die when you don’t want them to die,” one family member said.
“MAID policy is often framed as purely about autonomy. But health care has never treated autonomy as absolute,” said Dr. Ramona Coelho, a family physician and member of the Ontario’s Office of the Chief Coroner’s MAID death review committee.
“Most families are not asking for veto power,” she said. “They are asking to share information, to be involved and to know that all safeguards and care options were meaningfully considered.”
National Post
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