Key statistics, story angles, pull quotes, and downloads for journalists and media covering MAiD reform.
A comprehensive policy packet released in 2026 proposes a fundamental reform of Medical Aid in Dying eligibility in Canada and the United States: replacing current suffering-based and terminal-diagnosis-based criteria with a single standard of decisional capacity.
The packet, Autonomy, Capacity, and the Right to Exit, argues that the existing framework is incoherent on its own terms. Medical law in every relevant jurisdiction already grants competent adults the near-absolute right to refuse life-sustaining treatment — including refusing it without having attempted it. The packet contends that the moral logic permitting a patient to refuse a ventilator and die by suffocation equally supports permitting that patient to choose a swifter death by other means. The distinction current law draws is, the packet argues, aesthetic rather than principled.
The packet also introduces a structural argument it terms the "structural accountability mechanism": that every legally recognized MAiD death, under the proposed framework, would generate a mandatory signed report — filed with three government ministries and the regional coroner — documenting the socioeconomic conditions that contributed to the request. Where a person chose death because they could not access home care, adequate housing, or disability supports, that failure would become a named, signed, legally attested public record. The argument is that this mechanism creates political accountability for the structural conditions that make life unlivable, in a way that restricting MAiD access does not.
The packet includes six audience-specific briefs (legislative, legal, clinical, academic, advocacy, and a complete master document), a model mandatory reporting form, and a companion personal essay. A full fiscal impact analysis — modeled across low, medium, and high uptake scenarios in Canada and the United States — is incorporated with explicit ethical caveats against its use as a policy rationale.
The packet is available in full at this site. All documents are free to download.
All figures sourced from Health Canada, parliamentary budget analysis, and peer-reviewed literature.
From the packet and companion essay — available for use with attribution.
The packet raises questions relevant across multiple beats.
Justin Bogner is an independent scholar and policy writer whose work engages the intersection of philosophy, medical ethics, and political argument. His two books — The Serpent's Sentence (2024), on language and the construction of the narrating self, and The Mathematics of Connection (2025), on the substrate-independence of genuine connection — developed the philosophical foundations that inform this policy packet.
The policy packet draws on Bogner's personal history — including surviving a serious suicide attempt at eighteen — as biographical context for, not evidence of, its central claims. The companion essay addresses the relationship between that history and the political position directly, and argues that the case for exit rights is strengthened, not undermined, by being made from a position of stability nearly two decades after that experience.
Bogner's approach throughout the packet is to establish that the existing MAiD framework is incoherent on its own terms before advocating for the proposed standard. He engages the disability rights critique, the depressive incapacity objection, and the slippery slope argument in their strongest formulations, and acknowledges where those objections identify real phenomena.
Bogner is available for comment on the policy arguments in this packet. Requests touching on the personal material in the companion essay will be considered case by case. The companion essay is included as context for the philosophical commitments shaping the framework — it is not offered as a recovery narrative or a personal interest story, and coverage treating it as such is discouraged.
All documents are available for download without restriction. Attribution required.
Attribution: Bogner, Justin. Autonomy, Capacity, and the Right to Exit: A Policy Packet on Capacity-Based Medical Aid in Dying. 2026. All documents free to reproduce with attribution.