Medical assistance in dying in rural communities: A review of Canadian policies and guidelines

In June 2016, the Canadian Parliament passed Bill C-14, legalizing medical assistance in dying (MAiD), elsewhere known as voluntary euthanasia or physician-assisted suicide. Related legislation and policies continue to evolve. However, there is a paucity of scholarship regarding their distinct implications for rural communities. This is significant given that rurality is an underrecognized but important determinant of health. In order to address this gap, we conducted a rural-focused scan of policies, guidelines, and legislation that govern the practice of MAiD in Alberta, Canada (N = 16). Drawing from rural health scholarship, we reviewed these documents with a focus on three key rural considerations (place, community, and relationships) and identified potential implications. Through an analysis of these findings, we identified four opportunities where policy can better serve rural communities. These included addressing geographic location, continuity of care, dual relationships, and systemic barriers. In light of this, we offer several recommendations for how future policy and guidelines can better support rural residents. •We conducted a policy scan regarding medical assistance in dying (MAiD) in Alberta, Canada.•These documents were reviewed using the rural health concepts: place, community, and relationships.•We found urban-oriented assumptions about social dynamics, healthcare provider availability, and access to services.•Policy improvements are recommended to address geographic location, continuity of care, and systemic barriers.•Specifically, policies should address physician shortages, dual relationships, and transitions in care.