Monitoring medical assistance in dying (MAiD) in Canada: Perspectives of physicians, nurse practitioners, and organizational regulatory actors

Canada's federal monitoring system for medical assistance in dying (MAiD) commenced in 2018 and was expanded in 2023 to enhance data collection. This article sought to understand the role of monitoring in the regulation of MAiD in Canada. It reports on qualitative interviews conducted with 68 participants from two key groups: MAiD assessors and providers; and "organizational actors" from a range of bodies including government, regulators, professional organizations, and healthcare organizations. Participants' views of the monitoring framework for MAiD were analyzed. There was consensus that monitoring should be distinguished from oversight. Participants thought the monitoring system provided important transparency into MAiD practice but emphasized mitigating burdens on practitioners, where possible. Methods of data collection varied, and a pan-Canadian approach was challenging. Participants had different views about the appropriate scope of data. The article concludes with recommendations for effective monitoring of assisted dying practices.