Advance Consent for Medical Assistance in Dying: Perspectives from Canada

Ms. Caroline Variath1

1University Of Toronto, Toronto, Canada, 2Humber College ITAL, Toronto, Canada

Background. In March 2021, amendments to the Canadian medical assistance in dying (MAiD) legislation with the enactment of Bill C-7 allow eligible people who lose decision-making capacity to access MAiD using advance consents. There is minimal data in the literature on perspectives on using eligible patients’ advance consent to provide MAiD following the loss of decision-making capacity. This study explored healthcare providers’ perspectives on honouring eligible patients’ advance consent to MAiD following their loss of decisional capacity.

Method. A critical qualitative methodology and a feminist ethics theoretical lens with a focus on power, autonomy, and equity, were used to examine how socio-political and environmental contexts influenced healthcare providers’ perspectives. The data includes virtual, semi-structured interviews with 30 healthcare providers from across Canada who provide MAiD-related care. We conducted a thematic analysis of the data, guided by the feminist ethics lens.

Results. Preliminary themes identified include; 1) balancing personal values and professional responsibilities, 2) anticipated benefits of using advance consents, 3) relational influences on decisions, 4) contextual factors that may impede access to MAiD using advance consents and 5) impact of changes in legislation on healthcare providers.

Discussion. To our knowledge, this is the first in Canada to explore healthcare providers’ perspectives on using advance consent to provide MAiD. Although most participants support the availability of advance consents, they expressed concerns with its implementation and use. Anticipated challenges include the increased workload, difficulties in establishing unbearable suffering, and family objection. Participants indicated they would honour advance consents on a case-by-case basis.


Caroline Variath is a PhD Candidate in nursing with a collaborative specialization in bioethics at the University of Toronto. Her PhD thesis focuses on healthcare providers’ experiences with eligible patients’ loss of capacity to consent and access to medical assistance in dying in Canada.


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