Digital Stories about
Medical Assistance in Dying (MAiD):
A Tool Kit
Acknowledgements
This tool kit was created within a larger study at Lakehead University (REB #1470167) supported by a Social Sciences and Humanities Research Council of Canada (SSHRC) grant.
The researchers acknowledge partnerships with the Centre for Research and Education on Aging & Health (CERAH), Bridge C-14, MAID Family Support Society (MFSS), and Mike Lang Stories as integral to the study.
Notes for the facilitator
The stories you are about to view range in length from 3:35 and 5:53 minutes.
Although brief, these may be difficult minutes for you and for members of your group. It is our hope that they will also be very important and rewarding minutes, too.
We ask that you take care of yourselves gently as you lean in. Please use this guide as a starting point for your discussions.
We always welcome feedback about the stories and audience response. Please use the Comment card at the end of this tool kit or reach out to us at: disruptingdeathmaid@gmail.com to let us know about your experience.
Background information
Quick view: Digital storytelling is
● Owning Insights and Emotions: Individuals explore their own perspectives and feelings related to the loss.
● Finding the Moment: Identifying a specific event or experience to focus on in the story.
● Assembling and Sharing the Story: Creating the digital narrative and sharing it with others.
More about digital storytelling
Digital storytelling has its roots in the 1990s, its inception widely attributed to Joe Lambert and the late Dana Atchley, at the Center for Digital Storytelling in Berkeley, CA, who sought to democratise experiences of media creation (StoryCenter, 2022). As such, digital storytelling does not require professional equipment and/or technological skills beyond basic competency to use a specific software platform (in our case, WeVideo). Digital stories are usually 2–3 (and commonly 3–5) minutes in length, have a first-person narrative, and may use still and/or moving images, music, or sound effects to tell a story about a person, event, or issue (Lambert, 2009). There is no fixed curriculum involved in the model of digital storytelling at the Story Center; this flexible approach can then contribute to an empowering experience for the creator (Juppi, 2017; Wexler et al., 2013), and often a transformative one for both creator and viewer (Alexandra, 2008). In addition, while our study purchased a software licence to provide the digital storytelling platform to participants, there is also a less-enhanced version available free of charge (WeVideo). Access to this platform ensured participants had equitable access to royalty-free images and sound and was in keeping with setting the process up for success from the outset. Traditionally, DST engages participants in intensive group-based workshops, usually numbering eight to 12, over the course of several days, with facilitators guiding the creative process and troubleshooting the technological aspects (Lal et al., 2015). Some evidence suggests that while the workshop culminates in a product—the digital story itself—it is the process of creating one that is of more value to the participant (Juppi, 2017). However, in terms of research methodologies, it is understandable that the dissemination of the stories could be integral to the study (Lenette et al., 2019), if they are devised with educational purposes in mind.
Digital storytelling and grief
Storytelling has long been used in grief and bereavement explorations as it provides opportunities for sensemaking (Gilbert, 2002), catharsis (Bosticco & Thompson, 2005), continuing bonds (Valentine, 2008), and meaning-making when processing a loss (Gillies & Neimeyer, 2006). The concept of meaning-making is relevant in grief explorations as it is the process by which the bereaved come to understand, navigate, and make sense of their loss (Supriano, 2019). Digital storytelling as a multimodal approach enhances these meaning-making processes, potentially realising its expression to a greater degree (Johnson & Kendrick, 2016). In keeping with Bruner (1990) and the idea that narratives are how we bring order to our lives, digital storytelling asks the griever to make creative and multimodal (Yang, 2012) decisions regarding images, sound, and/or music in addition to the narrative, and to keep the story to a fixed time and pace. This provides an order to the storytelling process as individuals navigate the loss and extends beyond the narrative. Digital storytelling as a meaning-making bereavement tool also allows for potential explorations of continuing bonds, addressing unfinished business, benefit finding, and sense making (Rolbiecki et al., 2021). Returning to the notion of catharsis, while digital storytelling itself is not therapy, it is valued as a therapeutic intervention in palliative care (Akard et al., 2016) and grief and bereavement work (deJager et al., 2017).
From:
Durant, K.-L., & Kortes-Miller, K. (2023). “And Then COVID Hit”: (Re)flexibility of Digital Storytelling in Qualitative Health Research. International Journal of Qualitative Methods, 22. https://doi.org/10.1177/16094069231170953
MAiD-Related Grief and Bereavement
More than 320,000 people died in Canada in 2023 (Statistics Canada, 2023), and 15,300 of those deaths - about one in 20 or 4.7% - were medically assisted (Fifth Annual Report on Medical Assistance in Dying (MAiD) in Government of Canada, 2023). The number of MAiD provisions in 2023 represents a 15.8% increase over 2022 (Fifth Annual Report, 2023). As the legislation evolves, there is a need to learn more about the unique needs of those grieving a medically assisted death to provide appropriate supports.
In Canada, grief literacy rates are far lower than the ideal, which counters the notion that death and dying should be housed within clinical and institutional contexts (Breen et al., 2022). MAiD-specific grief and bereavement rates, reasonably, follow this pattern and would also benefit from community-based practices and conversations about dying, death, and loss that serve to raise death and grief literacy rates at large (Breen et al., 2022). While the grief experience is unique to the individual and based on myriad contexts, grieving a medically assisted death can involve particular factors and, as such, requires specialised forms of support (Frolic et al., 2020; Serota et al., 2023, 2024). In their scoping review, Yan et al. (2022) highlight concepts that impact the grief and bereavement of family and friends of someone who chooses MAiD, including relationships between family and friends; aspects of MAiD grief, e.g., secrecy and anticipatory grief; and the aftereffects of a MAiD-related journey. In addition, there is also the issue of both geographical and societal isolation in grief and bereavement experiences as MAiD deaths are less common, can be stigmatized and met with judgement (Frolic et al., 2020; Serota et al., 2023; Thangarasa et al., 2021) and/or may result in a struggle to identify and obtain what help, anticipatorily and after the death, is needed (Smolej et al., 2023).
From:
Durant, K.-L., & Kortes-Miller, K. (2025). Exploring Medical Assistance in Dying (MAiD)-Related Grief and Bereavement Through Virtual Digital Storytelling Workshops. International Journal of Qualitative Methods, 24. https://doi.org/10.1177/16094069251371464
Pre-viewing activities
The following are suggested activities before viewing the digital stories.
Give me two minutes
This is a listening exercise to help reinforce a culture of active listening while the stories are being viewed.
Divide the group into pairs. Each person takes turns sharing a challenging experience or situation. They are limited to three minutes to do so. As each person shares, their partner must remain silent; there can be no interjections, no responding at all. This includes agreement or commiseration, verbal or non-verbal. Absolute silence is the goal.
After both rounds, have the group share responses about what was easy to do while listening, challenging about listening, what was reinforced, learned, etc.
Paraphrasing circle
Have the group sit in a circle. One person starts by sharing a short story or experience. The person to their left then paraphrases what they heard, focusing on the key points and emotions expressed. The process continues around the circle, with each person paraphrasing the previous speaker's message.
After every person has shared their story/experience and participated in paraphrasing, ask the group their general responses were to the exercise. Ask the group to consider if they agree with how the stories were paraphrased, or if they would have done things differently. Finally, ponder how stories have the potential to change with every telling and according to every listener.
Draw what you hear
Two people sit back-to-back, both with a paper and pencil in front of them. One person is designated the questioner and the other is the responder. Without the questioner being able to see, the responder first creates a drawing using a variety of simple geometric shapes on a piece of paper.
Once the drawing is completed, the questioner asks questions, one at a time, about the shapes the responder drew on their paper. Listening carefully, the questioner then takes those answers and draws the design they believe they’re hearing be described. Once completed, the two participants compare the likeness of their drawings.
This activity bolsters a person’s ability to ask pertinent questions and to seek clarifications to better understand a subject.
A guide to effective viewing of digital stories
To effectively view digital stories, focus on the narrative and how the various media elements (images, audio, video, text) contribute to the story's message.
Pay attention to the point of view, dramatic question, and how the story builds to its conclusion.
Consider the length and scope of the story, and be open to the creator's perspective and personal experience.
Understand the components
Point of view (POV): Identify the central message or perspective the story is trying to convey.
Dramatic Question: Look for a central question that drives the narrative and keeps you engaged.
Narrative structure: Digital stories, like other narratives, have a beginning, middle, and end. Notice how the story unfolds and builds to its conclusion.
Engage with the media
Visuals: Pay attention to the images, videos, and other visual elements. How do they enhance or complement the story?
Audio: Listen to the music, sound effects, and narration. How do these elements create mood, tone, or meaning?
Text: If text is used, note how it contributes to the story's clarity and impact.
Consider the story's scope
Brevity: Digital stories are typically short (2-5 minutes), so the topic should be focused.
Personal Perspective: Be open to the creator's personal experiences and how they might relate to the broader topic.
Context is key
Purpose: Consider why the story was created and what message the creator is trying to share.
Audience: Think about who the story is intended for and how it might resonate with different viewers.
Community: Digital stories can foster understanding and connection within communities.
Be an active viewer
Empathy: Try to connect with the story on a personal level and understand the creator's perspective.
Reflection: Consider how the story might relate to your own experiences and perspectives.
Discussion: If possible, discuss the story with others and share your interpretations.
Adapted from:
https://www.library.yorku.ca/ds/home/media-creation-lab/digital-storytelling/
The stories
Dreams of You
Synopsis
Created by Sigrid, a woman caring for her husband, Charles, diagnosed with early-stage Alzheimer's. As his condition worsens, Charles expresses his desire to avoid a future tainted with a diminished quality of life. After learning he is eligible for MAiD, the couple navigates the complicated and stressful application process. Charles is eventually approved, and he peacefully passes away with his wife by his side, grateful for the ability to choose his own end and die with dignity.
Questions
• How can healthcare providers or MAiD assessors avoid assuming what an individual might want and instead focus on asking them about their own plans and desires?
• How do societal attitudes toward dementia and cognitive decline shape the experiences of individuals and families making end-of-life decisions?
• How can we balance respecting an individual’s autonomy with concerns about their ability to make decisions?
Notes from Annie
Synopsis
Created by Dave, a caregiver for his partner, Annie, who lived with ALS and then a cancer diagnosis. Unable to speak or care for herself and only able to communicate through writing notes, Annie expedites the MAiD request. Dave struggles with guilt, exhaustion, and the challenges of caregiving but also recognises the control MAiD gives Annie in her final moments.
Questions
• How can we ensure that individuals choosing MAiD are making the decision for their own reasons rather than due to caregiver burnout or a lack of support?
• How can communication be preserved when verbal communication is no longer possible to address the person’s wishes and needs?
• How do you think the choice of MAiD affects the relationship between the person choosing it and their caregiver?
As Good As Death Can Be
Synopsis
Created by Lynn about her husband John’s journey with ALS and decision to pursue MAiD. After his diagnosis, they openly discussed his choice and the idea of death, expressing that he would only be ready when he felt he could no longer care for himself. As time passed, John declined further medical intervention and ultimately chose a date to end his life. He died peacefully, surrounded by his family.
Questions
• How can we acknowledge anticipatory grief while still maximising the time spent with our loved one before they undergo MAiD?
• How can we support our patients’ choice to pursue MAiD while respecting their decision to decline life-preserving interventions?
• How can we recognise when we or a loved one are truly ready to die? Is this something we can come to understand, or is it simply a feeling we "just know"?
Fatherless Daughters
Synopsis
Created by Cynthia, who interweaves her experience with her husband’s choice of MAiD into this exploration of her father’s subsequent choice. As she navigates these emotionally charged experiences as a daughter, she compares her story with that of her young daughter’s experience of her father’s choice of MAiD. She explores the complexities of grief, caregiving, and the emotional toll of witnessing her loved ones’ end-of-life decisions.
Questions
• How can an individual’s loved ones be assured that MAiD was the right choice when they can never truly know how much time their loved one had left?
• How can individuals be acknowledged and supported in their grief while balancing the responsibilities of being a parent, spouse, etc.?
• How do powerful personal stories like this, such as a child losing a parent, challenge or support public opinions about MAiD?
Writing the Ending
Synopsis
Created by Robin as she reflects on her father's life as a storyteller and his decision to pursue MAiD due to his worsening lung disease. This story is unique in that it includes her father’s voice in the audio segments. Initially shocked and unsure about MAiD, the family supported his choice, spending time together and revisiting old stories before his death. Robin acknowledged the bittersweet nature of knowing the end was coming and appreciating that MAiD allowed her father to control his final chapter.
Questions
• How might the experience of saying goodbye be more difficult when you know the exact time and date of a loved one’s death, as opposed to only having a rough idea of when it might happen?
• In what ways does controlling one’s death, or "writing their own story," allow the individual to leave behind a legacy?
• What role might the telling of stories have in helping families grieve?
A Perfect Ending
Synopsis
Created by Jo-Anne, a death doula who supported her friend Jan’s choice of MAiD. As Jan’s health declined, she chose to prioritise quality of life, declining medical interventions beyond pain and symptom management. Jo-Anne supported Jan through the decision, sharing the concept of MAiD with her family and helping them navigate the difficult conversations and processes until the end of Jan’s life.
Questions
• In what ways can death doulas or other forms of support help individuals navigate the emotional and practical challenges of MAiD?
• How can medical practitioners become more comfortable accepting individuals’ decisions to decline life-sustaining measures?
• How can we promote a culture where discussing end-of-life choices, final wishes, and goodbyes becomes more open and natural?
Both Sides: A Chaplain's MAiD Story
Synopsis
Created by Trish, a hospital chaplain who, after supporting a religious woman through her choice of MAiD, faces a similar situation when her husband, diagnosed with cancer, opts for MAiD. His peaceful death brings her both comfort and questioning reaction from within her faith community. She finds support in connecting with others who have experienced MAiD and uses her personal journey to offer support and understanding to families in similar situations.
Questions
• How can religious beliefs and MAiD be reconciled for individuals who are interested but hesitant due to their faith?
• How can faith communities better support individuals who have experienced a loved one’s choice of receiving MAiD?
• How might faith-based practices and institutions accommodate and support Canadians and their families when considering and accessing MAiD?
Something We Could Share
Synopsis
Created by Roberta (Bobbie), this story is about a once-highly active man, Bob, diagnosed with Parkinson’s disease. As his health declined rapidly, leading to hospitalisation and a loss of independence, the decision to pursue MAiD was made. He was able to return home and spend time with his wife and many loved ones before his chosen date, allowing his remaining days to reflect the active lifestyle he had cherished.
Questions
• How does the ability to plan one’s final days contribute to maintaining dignity and agency for an individual with a terminal illness?
• How can individuals experiencing a loss of independence be supported in their decision to pursue MAiD?
• What ethical considerations arise when supporting individuals falling under Track 2, where quality of life is significantly diminished but death is not imminent?
We Didn’t Waver
Synopsis
Created by Kimberly, whose husband, Paul, chose MAiD after living with Parkinson’s disease. She is candid about how he was eventually no longer able to live at home. Kimberly stressed that Paul might lose his narrow window of eligibility for MAiD due to the complicated assessment process. The emotional strain of the lengthy and impractical process is highlighted, including the fear of not being approved. Kimberly shared that this struggle became a path for her to become more involved in the MAiD community of practice.
Questions
• How can healthcare providers balance compassion with the need to adhere to legal safeguards when assessing MAiD requests?
• How can policies around MAiD be improved to better account for the nuances of individual health situations, especially for those with conditions that involve cognitive fluctuations?
• Ideally, what are the most important factors to consider when determining eligibility for MAiD?
MAiD: A Servant In Deed
Synopsis
Created by Diane, a prolific writer who has lived with multiple sclerosis (MS) since she was 17. Diane shares her journey of resilience and highlights the significance of writing as a source of strength and purpose throughout her life. She also expresses gratitude for the option to access MAiD when she and her husband feel the time is right.
Questions
• How does Harry’s initial reaction to Diane’s proposal of MAiD as an option reflect the stigma surrounding this choice?
• How can we respect someone’s choice to use MAiD while supporting the emotional needs of their loved ones?
• What might help someone who opposes MAiD better understand and accept an individual’s decision to end their suffering?
Overtime
Synopsis
Tania recounts her experience with her father's decision to pursue MAiD after years of debilitating pain. She notes that her family is well-educated about MAiD but not its processes. Meeting the criteria for Track 2, which requires a 90-day waiting period for non-terminal cases, her father's suffering had Tania questioning the necessity of this seemingly arbitrary before administration. She compares this to the decision to euthanize a pet, questioning the rationale behind such a delay. Tania advocates for policy reform that prioritises quality of life and minimizes suffering for individuals awaiting MAiD and their families.
Questions
• What does comparing MAiD for humans to euthanasia for pets reveal about how we view suffering, death, and the ethical choices surrounding them?
• How can MAiD policies be improved to better balance safety measures with the need to reduce unnecessary suffering for individuals and their families?
• How can we ensure that individuals' decisions about MAiD are fully informed and voluntary, especially when they are experiencing severe pain or decline?
Broken Things
Synopsis
Created by Lorraine who recounts her experience with her husband, Michael, who chose MAiD after being diagnosed with terminal cancer. Michael had witnessed his father's painful death and was adamant that he would not face the same fate. The couple made the most of their time together and were preparing for MAiD but Michael lost consciousness shortly before the procedure; this was heartbreaking and isolating for Lorraine. She found peace on that last day through a supportive physician and then committed herself to supporting others in the MAiD community.
Questions
• How can we help individuals and families mentally process the initiation of MAiD, especially considering how quickly quality of life can deteriorate, making the decision feel abrupt?
• How does maintaining communication with patients, despite their potential inability to comprehend information, maintain their dignity in their final moments?
• How does the realisation that an individual’s illness is actively progressing toward death influence their loved ones’ perception of MAiD?
A Brave Goodbye
Synopsis
This story follows Amy’s journey of supporting her father in choosing MAiD after a battle with cancer. Raised in a culture where discussing death is taboo, she struggles with the idea of supporting her dad's decision, fearing judgment from her family. Despite the pushback, she makes the difficult decision to honour his choice to end his suffering. As she navigates her grief, she reflects on how this difficult decision was the bravest thing she could do for her father.
Questions
• How can we approach discussions about MAiD with patients and families whose cultural beliefs about death may differ?
• How can we support individuals in their decision to pursue MAiD despite disapproval from family or community?
• How can we address the feelings of guilt that may arise from suggesting or opting for MAiD?
Post-viewing activities
Here are some questions for consideration:
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Thinking of the titles of each story, what general themes can be identified?
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Does digital storytelling have a place in the work that you do?
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Does digital storytelling have a place in your personal life?
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Will you share your experience of watching these digital stories with others?
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What other digital stories need to be made?
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What would your digital story be about?
This Word Cloud collects the ideas found in the stories.
Consider sharing to allow the group to compare their inferences.
Recommendations for further viewing
The following are recommended with the same proviso that you take care while viewing.
Resources & Supports
National
Disrupting Death: Conversations about Medical Assistance in Dying (podcast)
Email contact: disruptingdeathmaid@gmail.com
General website: https://www.disruptingdeath.ca/
MAiD in Canada (Substack)
General website: https://maidincanada.substack.com/
Bridge C-14 (peer support)
Email for more information: info@bridgec14.org
General website: https://www.bridgec14.org/
MAID Family Support Society (peer support)
General website: https://maidfamilysupport.ca/
Dying With Dignity Canada – chapters across Canada
https://www.dyingwithdignity.ca/en/ (English)
https://www.dyingwithdignity.ca/fr/ (français)
Canadian Association for Assessors and Providers (CAMAP) - location-specific resources
https://camapcanada.ca/for-the-public/maid-resources-by-location/
Canadian Virtual Hospice - MAiD-specific information and supports for regions in Canada
https://www.virtualhospice.ca/maid (English)
https://www.portailpalliatif.ca/amm/ (français)
My Grief: Grief and medical assistance in dying (MAiD) module for study
https://mygrief.ca/mod/lesson/view.php?id=893 (English)
https://mondeuil.ca/mod/lesson/view.php?id=885 (français)
Provincial/Territorial
Atlantic Canada
New Brunswick
Newfoundland and Labrador
https://www.gov.nl.ca/hcs/files/Medical-Assistance-in-Dying-MAiD.pdf
Nova Scotia
https://www.nshealth.ca/sites/default/files/documents/2229-2024.03.13.pdf
Prince Edward Island
https://www.princeedwardisland.ca/en/information/health-pei/medical-assistance-in-dying
Central Canada
Ontario
MAiDHouse - Toronto
MAiDHouse is a non-profit organisation devoted to providing those eligible to receive medical assistance in dying (MAiD) with a supportive, inclusive and home-like setting.
https://www.maidhouse.ca/
PDF of supports:
https://www.ottawahospital.on.ca/en/documents/2019/12/maid-grief-and-bereavement-resource.pdf/
Québec
Province du Québec CIUSS:
https://www.ciusss-capitalenationale.gouv.qc.ca/personnel-sante/soins-palliatifs-fin-vie/aide-medicale-mourir (français)
Association québécoise pour le droit de mourir dans la dignité:
https://aqdmd.org/ (français)
https://aqdmd.org/en/ (English)
Northern Canada
Northwest Territories
https://www.hss.gov.nt.ca/en/services/medical-assistance-dying-maid
Nunavut
https://www.hss.gov.nt.ca/professionals/en/services/medical-assistance-dying-maid
Yukon
https://yukon.ca/en/health-and-wellness/find-information-about-medical-assistance-dying#resources
Western Canada
Alberta
https://www.albertahealthservices.ca/info/Page14380.aspx
British Columbia
MAiDHouse - Victoria
MAiDHouse is a non-profit organisation devoted to providing those eligible to receive medical assistance in dying (MAiD) with a supportive, inclusive and home-like setting.
Manitoba
Shared Health MAiD Services
https://sharedhealthmb.ca/services/maid/
Saskatchewan
https://www.saskhealthauthority.ca/sites/default/files/2021-05/Grief-and-Bereavement-Handout.pdf