Canadian author Robert Munsch chose 'MAID' to end his life: What it means and how it works across countries

Canadian Author Robert Munsch - File Photo

Robert Munsch, the beloved Canadian children’s author behind classics like The Paper Bag Princess and Love You Forever, has revealed that he was approved for Medical Assistance in Dying (MAID), Canada’s legally regulated process for medically assisted death.

The 80-year-old, who has been diagnosed with dementia and Parkinson’s disease, told The New York Times that although his stories “are all there” he is “slowly slipping away.” In the same interview he explained, “I have to pick the moment when I can still ask for it,” because under Canadian law a person must retain decision-making capacity at the time MAID is provided.

Munsch also noted he applied for MAID years ago but has not yet chosen a date. His disclosure triggered a wave of tributes from readers and fellow authors. In response, his daughter Julie posted an update clarifying that while her father made the decision years earlier, he is “NOT DYING” anytime soon. She stressed that he remains stable, though degenerative conditions can worsen suddenly.

What is MAID in Canada?

Medical Assistance in Dying is a legal process that allows eligible adults suffering from serious and incurable medical conditions to choose a medically assisted death. Legalised nationwide in 2016, MAID is regulated by the federal Criminal Code and administered by provinces and territories. It falls under the broader term “assisted dying,” which also covers assisted suicide and euthanasia.

There are two ways MAID can be provided in Canada. In clinician-administered MAID, a physician or nurse practitioner administers a lethal substance that causes death, usually through an injection. In self-administered MAID, the person is prescribed a lethal drug and takes it themselves. In both cases, the law mandates strict medical safeguards.

Who qualifies for MAID?

Eligibility criteria are designed to protect vulnerable people. Applicants must be at least 18 years old and eligible for government-funded health care, be mentally competent and able to make their own decisions, and have a grievous and irremediable medical condition causing enduring and intolerable suffering that cannot be relieved under acceptable conditions. They must make a voluntary request free from external pressure and provide informed consent before the procedure.

Importantly, Canadian law does not require someone to be on the verge of death to qualify. People with long-term or degenerative illnesses such as dementia or Parkinson’s can still be eligible if their condition is incurable, causes ongoing unbearable suffering and they meet all other legal requirements, including mental competence and informed consent.

Safeguards around MAID

Canada’s MAID law includes multiple safeguards. Two independent medical assessments are required to confirm eligibility. The person must submit a written request witnessed by someone not involved in their care. Consent must be reconfirmed just before the procedure unless specific exemptions apply, such as pre-arranged waivers for capacity loss.

The need to retain decision-making capacity at the moment MAID is provided explains why Munsch told The New York Times, “I have to pick the moment when I can still ask for it.”

Why Munsch chose MAID

Munsch has spoken openly about how dementia has changed his life. In a 2021 interview with CBC he said, “I can’t drive, I can’t ride a bicycle, I can’t write. So it’s been really whittling away on who I thought I was. My stories, strangely enough, are all there. The stories will be the last thing to go, I think.”

In a recent New York Times interview, he revealed that he was later diagnosed with Parkinson’s disease as well and intends to proceed with MAID once he loses the ability to speak and communicate, since the law requires him to still have decision-making capacity. His decision was also shaped by personal experience: he watched one of his brothers die slowly of Lou Gehrig’s disease (ALS), which convinced him not to endure a similar decline.

How assisted dying works elsewhere

Canada is not alone in permitting medical assistance in dying. Some form of assisted death is legal in ten US states and Washington DC, although these laws generally limit eligibility to patients with terminal illnesses and a prognosis of six months or less to live.

Several European countries, including Switzerland, Belgium, the Netherlands, Spain, Austria and Luxembourg, have more expansive frameworks. Some allow assisted dying even for people who are not terminally ill, including those with chronic or psychological conditions, provided strict consent and medical review criteria are met.

Australia has also legalised assisted dying in most of its states, while New Zealand allows it for patients expected to die within six months, a limit extended to 12 months for neurodegenerative illnesses.

India takes a different approach. Active euthanasia, the act of intentionally administering a substance to cause death, is illegal and punishable under the Indian Penal Code. But in 2018, the Supreme Court of India recognised the legality of passive euthanasia, which involves withdrawing life support or medical treatment from terminally ill or permanently incapacitated patients. The court also allowed individuals to issue advance medical directives, commonly known as “living wills,” stating their preference to refuse life-prolonging interventions if they become incapable of making decisions in the future.