This page explains what happens before, during, and after a medically assisted death. While each person’s experience is unique, the medical process follows a predictable sequence. Understanding what will happen next can help ease fear and uncertainty.
Reading this may feel difficult. You might notice grief, fear, sadness, or a mix of feelings that’s hard to name. All of those responses make sense. Move through this article at your own pace.
Pre-planning considerations
By the time medical assistance in dying (MAID) is scheduled, most questions about eligibility and safeguards have been addressed. But there may still be some practical concerns to settle.
In most cases, plans for what will happen after death must be made well in advance of the MAID procedure. Contact information for the funeral home should be given to the MAID provider and a family member or friend who will notify the funeral home after MAID.
You may wish to consider:
- whom you would like to be present
- where MAID will take place
- any words you would like to say – or have someone else say
- music you would like to hear or rituals that matter to you
- what should happen immediately after your death
Reflect on what matters most
MAID is a unique type of death that often provides an opportunity to create meaningful moments.
Take time to consider the people you’d like to say goodbye to, any small rituals you’d find comforting, and any final wishes you’d like to honour.
What to expect on the day of MAID
For many, the day of MAID is both a medical procedure and a meaningful gathering. Some spend time beforehand with close friends or family – sharing meals, music, or conversation. Other families prefer privacy and stillness. There is no right or wrong way to spend this time.
Your MAID provider will be present throughout the procedure, answering questions and providing support to you and those you’ve asked to be present.
When it’s time, they will administer medications that relax you, bring on a deep, unconscious state, and then stop your breathing.
Receiving the medications
MAID is usually provided intravenously. A health care provider – a registered nurse or the MAID provider – inserts an intravenous line, usually into an arm or hand. Often, they place a back-up line in case issues arise during the procedure.
When you’re ready, your MAID provider will ask once more if you want MAID. If the answer is yes, they will give the IV medications that result in death. Medications are given in a sequence to relax you, induce a coma-like sleep, then stop your breathing. People usually fall asleep within minutes and do not regain consciousness.
In rare cases, medications are provided as a liquid that the patient drinks in the provider’s presence. This method is less common, not available in all regions, and not paid for by all provinces and territories. When compared to intravenous MAID, oral medications are less predictable and take longer to work. When the timeline is longer than expected and prior consent has been given, intravenous medication may also be used.
What happens during death
When intravenous medication is used, the process is brief. Most people fall asleep almost immediately and die within 8 minutes of receiving the first medication.
What your supporters experience
Experiencing a MAID death is, in many ways, similar to being bedside at any death, except that the timing is known and it is often more peaceful and less emotionally charged, because it is expected. Your MAID provider will be present throughout, explaining what to expect and helping supporters prepare.
Because the medications act quickly, you and your supporters will be encouraged to share any final words before they are given.
After the medications are administered, supporters may notice changes such as slower breathing, changes in skin colour or temperature, relaxed facial muscles, or occasional movements or sounds. In the final moments, breathing stops.
Many families find that knowing what to expect helps. The atmosphere is often described as quiet and intimate, with time for holding hands, speaking softly, playing music, or sitting in silence.
What happens after death
Your MAID provider will confirm the time of your death. They may use a stethoscope, or check for a pulse at your wrist or neck. Once there is no heartbeat, they will let those present know that you have died.
After that, your supporters may want to spend time in the room, or they may wish to move to a different space.
In the hours following death, natural changes begin. The body cools, the skin may become pale, and muscles become stiff. These changes are normal. During this time, those present may want to keep the room cool.
The MAID provider will remain for a short time after the death to answer any final questions, leave a written death certificate to be given to the funeral home attendants, and ensure that next steps are clear for those present.
Next steps
A designated family member or friend will contact the funeral home to arrange transportation of the body. In some cases, families will be asked to arrange this in advance by letting the funeral home know the date and approximate time of MAID. If arrangements are not made ahead of time, there may be a longer wait before the funeral home attendants arrive.
Transportation does not need to happen immediately after death. For some families, it’s a matter of minutes, while for others, it’s hours. It is their choice.
Funeral home staff will need the death certificate in order to remove the body. In some provinces and territories the cause of death is MAID; in others it is the underlying medical condition that led to MAID eligibility. In some jurisdictions, there may be a follow-up call from the coroner’s office or MAID coordination service to a family member or friend to ask how the MAID process was for them.
Support in the hours and days ahead
Even when a death is planned, it can feel surreal for those present. Some family members describe a sense of calm. Others feel shock, relief, sorrow, gratitude – or many emotions all at once. All of this is normal. Learn more about what you might expect when grieving a loss.
“In her last moments, she was completely empowered.”