A new Cardus paper looks at the machinery around MAiD requests and assessments and compares Canada with other countries that allow assisted dying. The finding is uncomfortable. Canada sits between the tighter rules used in Australia, New Zealand and several American states and the more permissive European systems. On eligibility itself, Canada is already more open than those first-group jurisdictions. Safeguards that look adequate on paper work differently once the front door is that wide.
Rebecca Vachon, the paper’s author, walks through the practical details that rarely make the government talking points: who is allowed to raise MAiD first, how requests are witnessed, how assessors are chosen when they disagree, what expertise they need, whether families and existing physicians are notified, and what happens when a patient is found ineligible. In Canada, ineligibility is often not the end of the process. A person can keep looking for another assessor, including in another province, until someone says yes. Health Canada’s model practice standard also encourages physicians to raise MAiD as an option, which is the reverse of systems that require the patient to bring it up.
Families have raised cases in which they doubted the person’s capacity or the quality of consent. Mental illness already sits inside many of those disputes, and the scheduled 2027 expansion would make that tension worse rather than resolve it. Alberta has moved in the other direction, restricting unsolicited MAiD pitches from health professionals. That is a minority approach in a country that has spent a decade widening access and calling the result compassion.
Cardus’s last point is the one governments find hardest to answer. The strongest safeguard is not another form. It is whether a person facing serious illness, disability or despair actually has care, housing and treatment that make staying alive a real option. If those things are missing, the assessment process is being asked to do a job it cannot do: certify that death was chosen freely in a system that offered too little else. Provincial and federal governments should ask whether the current rules protect the people most likely to be steered toward MAiD. The comparison with other countries suggests Canada has been answering a different question: how quickly the option can be made available.
