MAiD in the Media – The Three-Party Problem

It’s been two months since we first posted this, but a recent experience made us want to share it again.

We need to be careful when reading media reports about specific MAiD cases. Very often, we hear only one side of the story, while the perspectives of the patient and MAiD provider are left untold or incomplete. We argued that those perspectives are often the most important ones—and that ignoring their absence can be dangerous and irresponsible.

Stories focused on grieving families or loved ones should not be dismissed. But we do need to acknowledge their limits. In many cases, we simply do not know the whole story.

We need to take great care when sharing these stories, and hold people accountable when they present one-sided or incomplete narratives as the full truth.

Originally posted on March 12th, 2026.

Journalist André Picard recently wrote a thoughtful piece in The Globe and Mail titled “In the MAiD debates, the patient’s voice must take precedence.” It touches on something we have been discussing privately for quite some time, but have hesitated to say quite this directly in public.

The difficulty is that saying it out loud requires acknowledging an uncomfortable reality: in debates about Medical Assistance in Dying (MAiD), not all voices carry equal weight. And pointing that out will inevitably offend some people — particularly those who have built their advocacy around speaking for others.

Picard notes that many of the MAiD stories receiving the most media attention share a common characteristic: the patient’s own voice is often absent from the narrative.

Instead, Picard points out, the narrative is shaped by others speaking on the patient’s behalf — usually grieving family members, or anti-MAiD activists with strong views about the legislation. Picard argues that this creates a distorted picture of how MAiD actually works, because the perspective of the person whose experience matters most — the patient — is often the least heard, if heard at all.

This is what we have begun calling “The Three-Party Problem”.

Here’s what we mean: there are typically three parties at the centre of every MAiD case — the person requesting MAiD, the medical team assessing them, and the person’s family.

Of those three parties, the patient and the clinicians responsible for assessing eligibility are the two voices most often absent from the media and public conversation. The patient is no longer alive to speak for themselves, and the clinicians involved are bound by strict professional confidentiality.¹

As an example, Picard references the case of Kiano Vafaeian, a 26-year-old who received MAiD in British Columbia in December of 2025, pointing out that since his death, his mother, Margaret Marsilla, has been calling for change and accountability. She believes her son’s intolerable suffering was solely the result of mental illness and that he should not have been found eligible for MAiD.

This is not meant as criticism of family members who speak publicly. They have lost a loved one, and any reaction to that loss is entirely understandable. But it is important to note that family members may only know part of the story — or sometimes none of it — particularly when there was conflict, family discord, or suffering that was never fully shared.

Our criticism is directed at those who take these deeply personal stories and turn them into political ammunition. Specifically, anti-choice organizations and media outlets that amplify a single account while knowing the two people most capable of explaining what happened cannot respond. When those partial accounts are then elevated and presented to the public as the full story, the result is a narrative that cannot be meaningfully challenged.

That is the Three-Party Problem in practice.

This dynamic becomes especially visible in controversial cases. As Picard notes, these stories are often “outliers, mired in difficult legal and ethical challenges.” Yet those complexities are frequently ignored in favour of sweeping claims about what “really” happened.

In the Vafaeian case, for example, critics of MAiD have insisted that mental illness must have been the “real” reason it was approved. But on what basis can anyone outside the clinical process make that determination about a particular patient? They do not have access to the confidential medical records, the MAiD assessments, or the conversations between patient and provider that form the basis of these decisions.

That process is confidential for a reason, and it means that many of the confident explanations offered in public debates are not based on privileged knowledge of the case, but on assumptions — assumptions that conveniently align with the narrative some anti-choice activists are eager to promote.

Asking broader questions about whether certain conditions meet the legal criteria for MAiD eligibility is entirely reasonable. Simply declaring that the documented medical context in a specific case does not matter — and replacing it with a preferred explanation — is something else entirely.

Cases like this illustrate the Three-Party Problem clearly. The people most capable of explaining the decision — the patient and the clinician — cannot participate in the public debate and are therefore replaced by speculation from those who were never part of the process.

What remains is a vacuum that can easily be filled by conjecture and ideology.

This does not mean MAiD decisions should be beyond scrutiny. Oversight and accountability are essential in any healthcare system. But responsible discussion requires acknowledging the limits of what we can know when the most informed voices cannot speak publicly. The reality is that neither anti-choice groups nor the general public have access to the full details of these cases.² There may well be legitimate questions about whether a particular decision was appropriate — but confidently declaring what “really” happened without access to the facts is not scrutiny. It’s ideology masquerading as objective certainty.

So the next time you encounter a story about a controversial MAiD death, it is worth remembering the Three-Party Problem.

In every MAiD case there are three voices at the centre of the story: the patient, the clinician, and the family. When you read those stories, it’s worth pausing to ask who is telling it — and what perspective, assumptions, or agenda may be shaping that account.

Because in many of the most widely shared public controversies, only one of those voices is able to speak. And the voice most central to the decision — the patient’s — is often the one missing from the story entirely.

1. Because clinicians involved in MAiD assessments are bound by strict professional confidentiality, the primary provider in this case could not comment publicly on the details of the patient’s circumstances and instead provided the following general statement to The Globe and Mail: “As with all my colleagues, I carefully assess each patient and each individual for whom I provided MAID had a grievous and irremediable medical (not psychiatric) condition causing unbearable suffering and causing an advanced state of decline in capability”.

2. We don’t either, which is why you don’t see us speculating on what might or not might have contributed to this or any other case.