The ‘Means Available to Relieve Suffering’: Translating Medical Assistance in Dying Safeguards in Canadian Policy and Practice

In Canada in 2021, people with non-life-limiting health conditions and disabilities became eligible for medical assistance in dying (MAiD). New legislative safeguards include a ninety-day assessment period and a requirement that health professionals engage with the person requesting MAiD about ‘means available to relieve their suffering’ (MARS). Government communications about the MARS safeguards emphasise distinct policy objectives, that we illustrate by analysing two texts. We then report on an ongoing study with health professionals involved in MAiD. In interviews, participants described supporting patients to imagine possibilities for feeling differently, creatively devising interventions, and actively connecting patients with (and in some cases bringing about) services and resources. Drawing on literature on front-line policy making we show how discourses of expert communication, care, and advocacy animate a specific translation of the MARS safeguards, one that recognises social and relational as well as deliberative autonomy, and reflects a range of MAiD policy goals.