Evidence map›Paper›PMID 41526056›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2026

Assessors' decision-making regarding applicant eligibility for Track 2 medical assistance in dying in Canada: a qualitative study.

Barbara Pesut, Sally Thorne, Helen Sharp, Michael McKenzie, Kenneth Chambaere, Mark Lachmann, Bregje D Onwuteaka-Philipsen, Lilian Thorpe, Lori Verigin, Alice Virani

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Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Barbara PesutSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC barb.pesut@ubc.ca.
Sally ThorneSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Helen SharpSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Michael McKenzieSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Kenneth ChambaereSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Mark LachmannSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Bregje D Onwuteaka-PhilipsenSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Lilian ThorpeSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Lori VeriginSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.
Alice ViraniSchool of Nursing (Pesut, Sharp), University of British Columbia Okanagan, Kelowna, BC; School of Nursing (Thorne), University of British Columbia; Division of Radiation Oncology and Developmental Radiotherapeutics (McKenzie), University of British Columbia, Vancouver, BC; End-of-Life Care Research Group (Chambaere), Ghent University and Vrije Universiteit Brussel, Ghent, Belgium; Temerty School of Medicine (Lachmann), University of Toronto and Sinai Health, Toronto, Ont.; Department of Public and Occupational Health (Philipsen), Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Amsterdam, the Netherlands; Departments of Community Health and Epidemiology and Psychiatry (Thorpe), University of Saskatchewan, Saskatoon, Sask.; Interior Health (Verigin), Kelowna, BC; Department of Medicine (Virani), University of British Columbia, Vancouver, BC.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2021, under Bill C-7, Canada revised its medical assistance in dying (MAiD) legislation to extend eligibility to individuals without a reasonably foreseeable natural death (Track 2). We sought to describe the clinical decision-making of assessors when determining applicant eligibility for MAiD Track 2.

methodsWe conducted semistructured virtual interviews of assessors practising in 4 Canadian provinces between April 2024 and March 2025. Interviews were audio-recorded, transcribed, checked for accuracy, and thematically analyzed, following the principles of interpretive description.

resultsTwenty-three assessors participated, including 14 physicians and 9 nurse practitioners. Participants described a comprehensive relational approach to assessment that included common understandings of what constituted capacity, voluntariness, and the purpose of the 90-day assessment period. We observed variability in how participants operationalized "a non-reasonably foreseeable natural death" - the defining criterion for Track 2 - and determined what constituted reasonable means to alleviate suffering of applicants. Assessors expressed concern about the risks associated with finding an applicant ineligible. Practitioners noted the value of peer or team-based consultation to robust decision-making processes, navigation of complex cases, and their own well-being as they navigated legally and morally complex assessments.

interpretationFindings suggest that Track 2 assessments are viewed as legally and morally complex and are conducted within a framework of relational autonomy that reflects MAiD jurisprudence. Best practice supports the implementation of a case consultation model in regions where this is not current practice.

Indexed as

Clinical Decision-MakingDecision MakingEligibility DeterminationSuicide, AssistedCanadaFemaleHumansInterviews as TopicMaleQualitative Research

Identifiers

PMID41526056
PMCPMC12768541

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.