Everything You Need To Know About MAID (But Didn’t Know To Ask)

When my father was diagnosed with terminal lung cancer in 2022, he told me he was considering MAID. At the time, about the only thing either of us knew about medical assistance in dying was that it was legal in Canada. Was he even eligible? 

Yes, it turns out. Once he was approved just three weeks later, we had more questions. Near the top of Dad’s list was what to wear. The nurse practitioner’s response helped me understand his concern was about dignity, not fashion. “Wear anything that feels right,” she said. “You won’t soil yourself.”

Although more than 60,000 people have died with MAID in Canada since it was legalized nearly a decade ago, many Canadians are still in the dark about how it works. I asked two experts to answer some of the most common questions families have—and some you might not even think to ask.

What is MAID, anyway?

MAID, or medical assistance in dying, is when a doctor or nurse practitioner helps an eligible person end their life. The government of Canada legalized MAID in 2016, after the Supreme Court of Canada found the laws that made it a crime to help someone die were unconstitutional.

Who is eligible for MAID in Canada?  

Anyone can apply for MAID, but approval requires assessments by two independent nurse practitioners or doctors. Dr. Stefanie Green, the Victoria-based founding president of the Canadian Association of MAID Assessors and Providers, says the criteria for approval are rigorous, with robust safeguards in place. 

Those safeguards mean that, in order to be eligible, you have to have an irreversible, serious and incurable illness, disease or disability that causes intolerable suffering that can’t be relieved by any means you find acceptable. Qualified assessors will review your medical records to confirm your eligibility and that you have seriously considered available treatment options. Your application must be voluntary, and you must understand the available treatment options, including palliative care. Green, who has conducted more than 400 MAID assessments, adds that applicants have to be over 18, entitled to government-funded healthcare and, importantly, able to understand the consequences of their decision and consent to it.

Is it okay to help someone apply for MAID?

Because I was afraid of feeling complicit in the death of my 81-year-old barely computer-literate father, I didn’t help him print or submit the application. Green says my concerns were unfounded: loved ones should feel free to help with the mechanics of downloading or completing forms. “To help navigate the healthcare system?” she says. “Lord, we all need that.”

How should one prepare for a MAID assessment?

“It’s not an exam you have to pass,” says Green. And while it’s not mandatory to include your family, she says many people find it valuable to have a loved one present. Dad invited me to attend his second assessment. Hearing him talk openly about his discomfort, fears and the ways his life had lost its meaning was profound. It helped me understand and make peace with his decision. 

MAID assessors can come to you for these conversations—whether you’re at home, in a long-term care facility or even in hospice. They may also be conducted by video chat.

Do I have to be terminally ill to be eligible for MAID?

No. In Canada, there are two separate tracks for MAID based on whether or not your natural death is “reasonably foreseeable.” If it’s not, there are additional safeguards in place. For example, you must first be informed of the means available to relieve your suffering and offered consultations with professionals who can provide those services before you can receive MAID.

That said, people whose only underlying medical condition is a mental illness are currently excluded from applying for or accessing MAID. This exclusion is scheduled to be lifted in March 2027.

Can I change my mind?

Absolutely. Paul Magennis, a registered nurse, MAID educator and co-author, along with registered nurse Kim Carlson, of MAiD in Canada, says the patient is in control and can “stop, pause, cancel…or change their mind at any point” up until the first medication is administered. 

First, Green obtains written consent from the patient. Then, “I always ask the patient if they’re ready to begin,” she says. “And for me, that's the final consent. They're always in charge of when it begins or when it doesn't begin, and they can still send me home until they answer that question. No harm, no foul.”

Will my life insurance pay out if I choose to die via MAID?

This is one of the most common concerns Green hears. MAID is considered healthcare, not suicide. So, as long as it is provided in accordance with the law, claims will be honoured, she says.     

Can I die in my backyard?

Magennis says you can have MAID just about anywhere you want, including most healthcare facilities. “It changes with jurisdictions, but there are ones that have happened in public parks with enough planning and approvals,” he says. Most common, however, is to die at home or in hospice. You can choose to be outdoors, in your favourite chair, in your bed surrounded by loved ones or even snuggling with your pets. 

Can I have MAID if I have dementia?

Many of us wish we could make an advance request that will trigger an assisted death if we meet a specific condition, like losing the ability to recognize our children. However, this option is not currently available outside of Quebec. 

That said, if you are diagnosed with dementia, MAID may be possible as long as you have the procedure while you still have the ability to understand the consequences of your decision. But cognitive challenges add significant complexity to the assessment process. “Many people with dementia will not be found eligible for MAID,” Green cautions.

That’s why Magennis advises anyone with dementia who is considering MAID to be followed closely by an experienced clinician who can advise when they are approaching “10 minutes to midnight”—a term that refers to the point at which you risk losing the capacity to consent. Not having a clinician follow you doesn’t immediately rule you out for MAID, Magennis adds, but it does make it easier for a clinician to support you when making the request.

Can I be an organ donor if I have MAID?

MAID medications do not harm your organs, meaning you may be eligible to be a donor as long as you meet organ donor eligibility requirements. In most cases, this means your death must take place in a hospital, so you’ll be close to an operating room.   

What should I know about the procedure?

Self-administered oral MAID is legal in Canada, though depending on the province you live in, a doctor or nurse practitioner will likely have to be present for the process. Still, the vast majority of people (more than 99 percent of cases) opt to have a nurse practitioner or doctor provide the medications through an IV. 

Magennis says the drugs used in the IV are the same ones used routinely in surgery and in ICU and emergency departments across the country, just in much higher doses. The first is a sedative that puts you into a light sleep—you might even snore. Next, a stronger drug induces a deep coma. The final medication is a paralytic that stops your breathing. The entire process takes about 10 minutes.

“The patient feels nothing other than comfort and sleep,” says Green. “There is no gasping, there is no choking, there is no coughing. It’s a peaceful, comfortable, witnessed death.”

What kind of ritual can I include?

Adding ritual and ceremony to MAID can transform a medical procedure into a healing rite of passage. Think music, candles or really anything that feels right for your family. (One procedure that Green administered took place following a luau for 50 guests.) Doing “the work of dying” is what’s important, says Green: “saying goodbye, saying thank you, saying I love you, saying I’m sorry.” 

What supports are available for my family after a MAID death?

Knowing the precise number of days and hours I had left with my father was surreal. I counted down a series of “lasts” and mourned Dad before he was gone. I felt relieved he would be free of his suffering, and guilty for feeling that way. In the midst of this anticipatory grief, I had no idea where to turn for support.

I was not alone. Magennis wishes more people knew about the many supports the healthcare system has to help families process and talk about this brand-new way of dying—from social workers and nurses to spiritual care practitioners and community support groups like MAID Family Support Society and Bridge C-14. “The sooner you have that kind of conversation,” he says, “the easier it makes the grieving process for everyone.”