The Writing on the Wind’s Wall: A Polyvocal Inquiry into the Ethical Landscape of Medical Assistance in Dying (MAiD)

As Canada’s legislative framework for Medical Assistance in Dying (MAiD) continues to evolve, the discourse often remains bifurcated between clinical-legal protocols and polarized public debate. This CHPCA Learning Institute session explores the necessity of a “dialogic” approach to bioethics—one that moves beyond administrative checklists to engage with the profound moral, social, and spiritual tensions inherent in end-of-life care.

Approach/Methodology:

Drawing from the recently published volume, The Writing on the Wind’s Wall: Dialogues About ‘Medical Assistance in Dying’ (2026, Guernica Editions), this presentation utilizes the format of the “philosophical dialogue” as a research methodology. By curating a community of voices—including medical practitioners, leaders of faith, relatives, and disability rights advocates—this work creates a discursive space where conflicting perspectives are not merely acknowledged but are placed in active, constructive tension. This method prioritizes the

“humanities-first” approach to healthcare, centering parallax as a primary source of ethical knowledge.

Themes & Findings:

Three core themes emerge from these dialogues:

• The Architecture of Autonomy: How individual choice is negotiated within the constraints of systemic healthcare inequities.
• The Clinical Encounter: The shifting identity of the medic from “healer” to “provider” of death.
• Marginalization and Safeguards: The critical dialogue surrounding the expansion of MAiD to include the “mentally ill” and the legitimate concerns of the disability community.

Conclusion & Implications:

The session concludes that a multidisciplinary, dialogue-based framework is essential for future policy-making. By embracing dissonant “polyvocality” rather than my-side-or-your-side-of-the-aisle debate, clinicians and ethicists can better navigate what current MAiD legislation and contextual praxis may miss.

After attending this session, participants will be able to:

1. Identify, Analyze, and Articulate Divergent Perspectives: Participants will be able to identify at least three distinct ethical viewpoints—ranging from clinical practitioners to disability rights advocates—regarding the expansion of MAiD, enabling a more holistic understanding of the “community of voices” involved in end-of-life care.
2. Apply Dialogic and Contextualizing Communication Techniques: Participants will be able to demonstrate two specific “dialogic” communication strategies (such as active listening across moral differences, the coincidence of opposing axioms, and open-ended inquiry) to facilitate more nuanced and empathetic conversations with patients and families navigating MAiD requests.
3. Evaluate Ethical Imperceptibles in Practice: Participants will be able to evaluate existing clinical protocols to identify potential “unknown-knowns” where systemic inequities or marginalized perspectives may be overlooked during the MAiD assessment process.
4. Integrate Medical Humanities into Care: Participants will be able to describe how incorporating literary and philosophical inquiry (the “medical humanities” approach) can reduce moral distress among healthcare providers by providing a framework to process the complex emotional and ethical tensions of end-of-life decision-making.

The Writing on the Wind’s Wall: A Polyvocal Inquiry into the Ethical Landscape of Medical Assistance in Dying (MAiD)
Wednesday, October 28th, from 12:00 pm – 3:30 pm (Eastern).

Kevin Andrew Heslop

Kevin Andrew Heslop is the author of several books of non-fiction and poetry, including “The Writing on the Wind’s Wall: Dialogues About ‘Medical Assistance in Dying'” (Guernica Editions, 2026), “it looks like a garden but he had hurt himself by accident” (Cactus Press, 2026), and the forthcoming “here lies the refugee breather who drank a bowl of elsewhere” (Biblioasis, 2027), “Craft, Consciousness: Dialogues About the Arts – Volume One” (Guernica Editions, 2027), and a co-authored memoir with intensivist Dr. Ian Ball (Guernica World Editions, 2028), as well as Canada Council for the Arts-funded works for the stage and screen.

He is also a venture capital investor in the surgical robotics space.

His most recent articles and poems have appeared with Amphora, The Fiddlehead, and The Walrus. Born in London, Ontario, Kevin currently divides time between Canada, Denmark, and Brazil.