Monitoring of MAID: Deficits of Transparency and Accountability

In Jaro Kotalik & David Shannon (eds.), Medical Assistance in Dying (MAID) in Canada: Key Multidisciplinary Perspectives. Springer Verlag. pp. 115-126 (2023)
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Abstract

Monitoring of MAIDMonitoring of MAID was recognised as an essential component of the MAID program. However, monitoring started late in the rollout of the program, and even at present is missing some essential elements that would be important for effective oversight and public accountability. Health CanadaCanada is using some of the data obtained from practitioners and pharmacists to produce Annual Reports on MAID, but these reports aim at providing only a “societal perspective,” rather than an in-depth assessment of the program’s performance. A major deficit is lack of monitoring and reporting on the compliance with eligibility criteria and procedural safeguards that should be coming from territorial and provincial governments, and that would provide assurance that MAID delivery complies with the Criminal CodeCriminal Code of Canada. Monitoring is based entirely on self reporting and therefore it is recommended that Health Canada obtain supportive data by initiation of on-site retrospective reviews of randomly selected MAID deliveries across the country. In addition, it would be useful to enhance the quantity and quality of data collected from MAID assessors and providers. Organizations involved in MAID provisions (hospitals, regional health authorities and so on) should also report annually on MAID activities to their respective communities. Improvement of monitoring and reporting would address serious concerns among professionals, people with disabilities and advocates for vulnerable populations while providing for a higher level of transparency and accountability.

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