To be eligible for medical assistance in dying (MAID), you must undergo two independent assessments. These clinical assessments by nurse practitioners or physicians confirm that you meet the eligibility criteria, and that your decision is informed and voluntary.
The assessors usually come to where you are, which might be at home, in hospital, or in a care home. In some situations, assessments may be done virtually.
Assessment appointments usually last 30 to 90 minutes, and sometimes longer. The overall process may vary from a few days to several months, depending on your circumstances.
Setting up your assessments
There are three common ways to arrange MAID assessments:
Through provincial or territorial MAID care coordination teams
In most parts of Canada, you can contact provincial or territorial MAID services directly, without a referral. Find your provincial or territorial team.
Through your health care provider
Health care providers such as nurse practitioners and physicians can do assessments themselves or refer you to a MAID assessor or provide contact information for your provincial MAID coordination service. Nurses, social workers and others in the public health care system may also be able to ensure you are connected with the appropriate people.
Some clinicians may choose not to provide MAID services for personal or religious reasons, or they may be unable to provide MAID services due to policies of the institutions in which they work. Depending on the province or territory, they may be required to provide a referral, or to direct patients to resources where they can find support. Learn more about your options if your provider will not support your request. In most parts of Canada, you can contact provincial or territorial MAID services directly, without a referral.
Through in-hospital MAID programs
If you are in hospital, your care team may coordinate MAID internally or connect you with a provincial or territorial MAID care coordination team.
Through provincial or territorial MAID care coordination teams
In most parts of Canada, you can contact provincial or territorial MAID services directly, without a referral. Find your provincial or territorial team.
Preparing for an assessment
You don’t need to prepare for these conversations, but some people find it helpful to:
- review the eligibility criteria
- gather key information about your medical history
- consider inviting a support person
- choose a quiet, private setting
Assessors may ask about these and other areas during a MAID assessment:
your personal situation, including your values and beliefs
your detailed medical history, both past and present
how you experience suffering
if you understand available treatment options
why you’re asking for MAID now
how long you have been considering MAID
if you have any fears about MAID
if you have concerns or questions
Possible assessment outcomes
Two assessors must confirm eligibility before MAID can proceed.
Assessors may share their decision immediately after the assessment; other times, they may need more time to review your medical history, consult others, or reflect. They will let you know when and how to expect an update.
Waiting for and learning the outcome of your assessments can be an emotionally heightened time. Learn more about what people commonly experience during the MAID assessment process.
After two assessments, you may be found eligible for MAID, receive differing conclusions from the assessors, or be found ineligible.
If you are found eligible
If both assessors find you meet the criteria, you can choose to move forward, but you do not have to. You may withdraw your request at any time, including immediately before MAID is provided.
If you receive differing conclusions
If your assessors reach different conclusions, the process cannot move forward.
Your MAID assessors or MAID care coordination service can help you understand the reasons for their conclusions and guide you through next steps, including arranging another assessment if you wish.
If you are found ineligible
If both assessors find you do not meet the criteria, MAID cannot proceed. They should explain the reasons for their decisions and identify which criteria were not met. If you feel your circumstances were not fully understood, you may seek other assessments.
If MAID is not available to you, your existing care team – nurse practitioners, physicians, specialists, and palliative care providers – remains responsible for supporting you.
Which legal track are you on?
Your MAID assessors will decide whether your natural death is reasonably foreseeable – or not. This decision places you on one of two tracks to MAID and affects the specific safeguards and timelines involved. Learn more about how these safeguards apply.
Planning ahead for MAID
If there is time, you may want to consider how you would like your death to unfold and share that information with the people closest to you.
Some people consider:
- where they would like to receive MAID
- how they would like to be positioned – for example, in bed, on a sofa, or on a chair
- whom they would like to be present and where they would like those people to be
- what music, rituals or meaningful details they would like included, and who will organize them
- whether any jewellery, watches, or other personal items should be removed, and if so, when and by whom
- whether they would like photographs, videos, or audio recordings of their death, and if so, who will ensure that everyone present has given explicit consent
You may also want to reflect on your values, wishes and priorities at the end of life. Use the Values Reflection Tool to consider what’s most important to you.
Getting support when you need it
Many people find MAID assessments an emotionally powerful experience. That might mean you feel stressed, nervous, curious, relieved, or something else. It’s all normal. Learn about some of the emotional responses that can arise when navigating MAID.