JOURNAL

 

An open-access journal for research, clinical reflection, and practice-oriented writing about suicide.

UNDERSTANDING SUICIDOLOGY: RESEARCH & PRACTICE  ·  VOLUME 1  ·  ISSUE 2  ·  MAY 2026

Standards without standardization: A review of Canada's Track 2 MAiD safeguards and ethical–legal ambiguities

Matias Gay, RN  ·  Understanding Suicidology: Institute for Research and Practice

 

ABSTRACT

Background: Track 2 medical assistance in dying (MAiD) in Canada, introduced through Bill C-7, increases reliance on bedside interpretation of indeterminate legal-clinical concepts and heightens the need for governable safeguards. Purpose: To review how Track 2 safeguards are defined, operationalized, and overseen, and to identify where ambiguity produces practice variability that is difficult to audit. Approach/Methods: Narrative review of statutory and federal interpretive materials, professional regulatory guidance, peer-reviewed scholarship, and federal monitoring reports, organized using a colour-coded rubric (LS, OG, CE, EV, MP, DL, EQ) applied across core safeguards and cross-cutting governance lenses. Findings/Argument: Across domains, safeguard strength is limited by “standards without standardization,” including under-specified documentation expectations and limited administrative auditability for inferential judgments in capacity, voluntariness and undue influence, irremediability, and serious consideration of reasonable and available means. Implications: Strengthening Track 2 governance requires minimum, reviewable documentation surfaces mapped to each safeguard, coupled with risk-informed chart audit and feedback, and explicit equity stress-testing where service constraints narrow feasible alternatives.

Keywords: medical assistance in dying; MAiD; Track 2; safeguards; Canada; ethics

Cite as: Gay, M. (2026). Standards without standardization: A review of Canada's Track 2 MAiD safeguards and ethical–legal ambiguities. Understanding Suicidology: Research & Practice, 1(2). https://doi.org/10.5281/zenodo.24039592

Download the full issue (PDF)  ·  DOI: 10.5281/zenodo.24039592  ·  All issues

Published by Understanding Suicidology: Institute for Research and Practice, Fredericton, New Brunswick, Canada. Open access.