Non-regulated but involved: Exploring the experiences of unregulated support providers in MAiD service delivery in Canada

Since its legalization in 2016, Medical Assistance in Dying (MAiD) in Canada has undergone significant development, yet the roles of Unregulated Support Providers (USPs) remain largely overlooked in research and policy discussions. This study investigates the experiences of and challenges faced by USPs supporting patients choosing MAiD in Canada. We conducted semi-structured interviews with 19 USPs across Canada, recruited via purposive sampling. Thematic analysis was employed to explore experiences and identify patterns of service provision, collaboration, and barriers to care. USPs offer emotional, educational, and logistical support to patients and families navigating MAiD-related decisions. Despite their contributions, they face barriers, such as financial inaccessibility and lack of formal recognition. Participants advocated for greater integration into the formal healthcare system and regulation to enhance accountability, accessibility, and patient safety. USPs can play an important yet overlooked role in MAiD. Their formal recognition could enhance psychosocial care for patients.