On June 17, 2025, the CBA Elder Law Section recently hosted a webinar addressing the legal updates and hot topics surrounding Medical Assistance in Dying (MAiD) in 2025. This article provides a high-level summary of the topics discussed.
Dr. Jocelyn Downie
Dr. Jocelyn Downie is a professor in the Faculty of Law at Dalhousie University in Nova Scotia. She provided helpful insight into the current status of MAiD law in Canada.
Dr. Downie reviewed that MAiD is the administering of a substance to a person, at their request, that causes their death. It can also mean the prescribing or providing of a substance to a person, at their request, so that they may self-administer the substance and in doing so cause their own death. This can be provided by physicians or nurse practitioners.
Dr. Downie reviewed the eligibility criteria, including that a person seeking MAiD must have a “grievous and irremediable medical condition”. Dr. Downie outlined what a “grievous and irremediable medical condition” could be classified as and clarified that “mental illness” is not considered to be an illness, disease or disability until March 2027. Dr. Downie outlined that there are two “tracks” that a person could pursue MAiD under and she explained the procedural safeguards in place for both of these tracks.
Dr. Downie noted that there are some interesting cases in court dealing with MAiD including institutional objection (“forced transfers”), mental illness as sole underlying medical condition, and Track 2 MAiD.
Amanda Cramm
Presenter Amanda Cramm is a Health Lawyer at Alberta Health Services (Calgary, AB). Her presentation focuses on specific interim injunction cases relating to MAiD that provide a snapshot of the current common law trends. The prevailing theme of the common law cases reviewed by Ms. Cramm, examined in Ontario, Nova Scotia, Alberta, British Columbia cases, is that the judiciaries will not make any clinical assessments to pre-authorize MAiD, and that these assessments do not fall within the scope of the Court. The cases also address the concepts of ‘doctor shopping’, judicial oversight and scope.
Dr. James Downar
Dr. James Downar, at the Ottawa Hospital (Ottawa, ON), presented while on-call and discussed the statistics in respect of the demographics of people receiving MAiD as well as a ‘how to’ in reading statistics and staying ahead of the common biases. His presentation provided an eye-opening perspective on MAiD recipients, highlighting potential gaps to be addressed as it appears that MAiD is provided to white/ Caucasian patients in the vast majority over and above other races. These statistics also appear to be at odds with the media coverage surrounding the use of MAiD as it relates to vulnerable & marginalized communities.
Me Pierre Deschamps
On the hot topic of Advance Requests (AR) in Québec, Me Pierre Deschamps , C.M., Ad. E., Quebec Research Centre of Private & Comparative Law (Montreal, QC) provided a detailed explanation of new legislative provisions effective October 30, 2024, which authorizes physicians and specialized nurse practitioners (SNPs) in Québec to provide MAiD in response to an advance request by a Québec health insured adult, under certain circumstances.
He covered all aspects of the Québec legislation in formulating, processing and administrating MAiD pursuant to an Advance Request, as well as practice aspects related to notarial, prosecutorial and physician CMPA advice.
Me. Deschamps reviewed who can make an Advance Request, how an Advance Request is made, the ability to designate a trusted third person to be involved and consulted, the formalities of the execution and its recording in the Advance Request register.
The role of the competent health professional advising the person wishing to make an Advance Request in the prescribed form is key to the entire process, which requires a thorough review of the person’s medical diagnosis, expected manifestations of their illness and potential treatment outcomes.
The legislation sets out the duties and responsibilities of any involved health and social service professionals, the health care team, any trusted third person or family members designated by the person to be consulted and the processing and administration process and procedures to be strictly followed prior to the provision of MAiD.
This involves a prescribed process of notification, opportunities to refuse or stop the process, inform the trusted third person, and multiple observations, assessments and examinations by multiple competent professionals. Once all of the other criteria are met, these competent professionals must both verify that the person who has been determined to have lost their capacity to give consent to treatment is exhibiting the exact clinical manifestations of the serious and incurable illness which they have determined to be the elements which are considered to express their consent to administration of MAiD.