An Analysis of Public Attitudes toward Medical Assistance in Dying (MAID) and the Associated Safeguards in Canada: A Systematic Review

Medical Assistance in Dying (MAID) has become a significant topic of public and ethical discourse in Canada since its legalization in 2015 following the Carter v. Canada Supreme Court decision. This systematic review examines public attitudes toward MAID, focusing on the influence of demographic, cultural, and socio-economic factors, as well as perceptions of the safeguards designed to protect vulnerable populations. The review, adhering to PRISMA guidelines, analyzed 13 studies published between 2015 and 2025, including public opinion polls, policy analyses, and qualitative research. Findings indicate strong public support for MAID, driven by principles of autonomy and dignity, with higher approval among younger, secular, and more educated individuals. However, opposition persists, particularly among older, religious, and conservative groups, who cite concerns about the sanctity of life and potential coercion of vulnerable populations. Safeguards, such as independent assessments and waiting periods, are generally viewed positively, though recent legislative changes, including the expansion of eligibility to individuals with mental illness and the removal of the 10-day reflection period, have raised concerns about their adequacy. The review highlights the need for ongoing public engagement, equitable access to healthcare, and transparent policymaking to address ethical dilemmas and ensure MAID aligns with societal values while protecting vulnerable individuals such as the older population, Individuals considering MAID, Religious or conservative individuals and persons lacking equitable access to healthcare. Recommendations include further research on public concerns, improved safeguards, and greater involvement of healthcare providers in policy development.