In July, I sat beside my mother as she received medical assistance in dying (MAiD). The process was calm, compassionate and meticulously planned. The medical team explained each step, physicians ensured safeguards had been followed and my mother’s wishes remained at the centre throughout.

By all accounts, it was a good death – peaceful, planned and consistent with her wishes.

In the days and weeks that followed, however, it became clear that, while Canada’s MAiD system knew exactly how to support my mother through her death, it was far less prepared to support those of us left behind.

This experience raises an important policy question: Has Canada built a comprehensive MAiD system for patients and providers, but not for families and loved ones? As policymakers continue debating who may access MAiD and under what conditions, they should also ask what obligations a compassionate health-care system owes to those who remain.

Patient-centred, family neutral care

Since the Supreme Court of Canada’s 2015 Carter v. Canada decision, Canada has developed one of the world’s most comprehensive MAiD frameworks, with successive legislative reforms, detailed eligibility criteria, procedural safeguards, provider standards and reporting requirements. Yet remarkably little attention has been paid to what supports families may require before and after a MAiD death.

As a result, Canada’s MAiD regime can be understood as patient-centred but largely family-neutral. While the person requesting MAiD is at the centre of decision-making, family members often accompany them through the entire process as caregivers, advocates, emotional supports and witnesses to the death.

After the death, they can face grief, guilt, moral uncertainty and social stigma in addition to administrative responsibilities and the challenge of rebuilding life without their loved one. Yet support for families remains one of the least developed components of Canada’s MAiD system, despite MAiD being authorized through federal law, with responsibility for delivering care resting with provincial and territorial health systems.

Research suggests that families affected by MAiD may encounter........

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