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I am a MAID provider. It’s the most meaningful—and maddening—work I do.

Canada’s MAID laws are missing fundamental safeguards for vulnerable people. That needs to change. By Madeline Li

Soon after I entered medicine in 2005, I realized that I was more interested in the human experience of illness than the illness itself. I completed a rotation in medical oncology while doing a combined MD and PhD in cancer research at the University of Toronto. The oncologist would talk to the patient about their cancer, their chances with treatment and so on—and then they would leave. It was the nurses and social workers who would stay to deal with questions like: “Oh my goodness, what am I going to tell my children?” I wanted to stay around for those conversations. I ended up specializing in cancer psychiatry at the University Health Network, or UHN, where most of my patients are dealing with cancer. What I find most engaging and meaningful is helping people deal with questions of life and death.

When MAID became legal in Canada in 2016, hospitals scrambled, trying to figure out how to respond. I’m in the division of psychosocial oncology at UHN, and our department head, Gary Rodin, stepped up and said we would take on designing MAID protocols. His reasoning was that our department is used to helping people grapple with death—that’s our specialty. He asked if I would volunteer to head up UHN’s MAID framework, and I jumped at the chance.

As the head of UHN’S MAID program, I oversaw hundreds of cases. I also personally provided MAID numerous times. I can’t tell you how many, because I don’t keep track. They’re not trophies—this is usual care. I see a lot of death: 60 per cent of my patient population in routine clinical care die. I don’t keep track of how I help them die, whether by MAID or my regular psychosocial care...

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