Medical assistance in dying (MAID) is the fastest growing option for Canadians whose deaths are reasonably foreseeable or who have intolerable conditions. Under Canadian law, you have to be assessed by two independent medical practitioners. This evaluation takes place over a period of at least 90 days if their imminent death cannot be reasonably anticipated. This legal framework creates two tracks for MAID patients thereby treating them differently. Track one includes patients whose death is foreseeable, allowing them to waive final consent, while track two encompasses those suffering intolerably without a foreseeable death, who must provide final consent at the time of the procedure.
MAID now represents approximately one out of every 20 deaths in Canada. New Brunswick has experienced a significant increase in demand for this service. One of them, the Vitalité Health Network, saw their requests soar, increasing from 105 in 2020 to 216 in 2024. By contrast, the Horizon Health Network experienced an even sharper spike, with requests jumping from 103 to 470 in the same period. Dr. Julia Wildish, a palliative care physician, noted this trend, stating:
"It's just been a continual increase in demand."
Chantale Arseneault, a regional MAID coordinator, explained the emotional toll of her work. She went on to call it the most rewarding job of her nursing career. She remarked on the deep connections formed with patients and their families:
"And I challenge that, because most of our patients are extremely grateful to not only tell us their story, but they become vulnerable with us and we make connections, deep connections."
One such sincere tale comes from Gerald and Coby Goguen, who have been already married for 41 years. Both had been deeply evaluated and found suitable candidates for MAID. Fighting a vicious form of prostate cancer, his health plummeted. In the interim, Coby continued to wage a courageous battle against cancer that had metastasized to her bones.
Their son, Lee Goguen, talked about his parents’ experience with MAID. He described their final moments:
"Mom and Dad were holding hands and looking at each other. The entire time the procedure was happening, they were holding hands."
He also reflected on the closure MAID provided:
"I have never experienced a death where I have had this much closure."
Dr. Julia Wildish explained the criteria for MAID candidacy, emphasizing the necessity of advanced functional decline and intolerable suffering that cannot be relieved by acceptable means to the patient:
"You have to be in an advanced state of functional decline, and you have to have intolerable suffering that can't be relieved by any means acceptable to the patient."
The Canadian government is working on an ambitious plan. Beginning on March 17, 2027, they will broaden eligibility under MAID to include people whose only underlying medical condition is a mental illness. Though first received with extreme skepticism, views on MAID are changing. Dr. Wildish observed that familiarity and personal connections have altered perceptions:
"I think initially everyone was a bit leery of the idea. It was sort of a new concept to people and kind of creepy maybe. But I think over time, people are more familiar with it. They know someone who's had it. They've had time to wrap their heads around the whole idea, and it's just not as scary."
